Impact of nutrition support team in achieving target calories in children admitted in pediatric intensive care unit

Document Type

Article

Department

Paediatrics and Child Health

Abstract

Objective: To determine the impact of Nutrition support team (NST) on achieving an early target caloric goal in mechanically ventilated children admitted in pediatric intensive care unit (PICU).
Methods: An early enteral nutrition protocol (EENP) was implemented by NST to ensure early and adequate nutrition provision to PICU patients. All children (1 month-18 years) that were admitted in PICU for more than 2 days and received mechanical ventilation, with no contraindications to enteral feed, were included and data was compared with those of pre-intervention. The adequacy of energy intake was defined as 70% achievement of target energy intake on the third day of admission. Chi-square/T-test was used to determine the difference between different variables pre and post intervention.
Results: Total 180 patients (99 and 81 in pre and post intervention group respectively) were included. Overall, 115(63.9%) received adequate calories (70%) on third day of admission. Of which 69(85.2%) were from post intervention (P < 0.001; OR 6.6, 95%CI 3.195-13.73). Moreover, NST intervention also promoted adequate protein intake in 62(76.5%) children compared to 37(37.4%) in pre-intervention group (P < 0.001, OR 5.468, 95% CI 2.838-10.534). The median (IQR) length of PICU stay in pre-NST group was 6(4-9) days and in NST supported group was 4(3-4) days (OR 0.580, CI 0.473-0.712, P < 0.001). Age, severity of illness, MODS, sepsis, need of organ support had no effect in achievement of caloric target in both the groups (p > 0.05).
Conclusion: Introduction of EENP with NST helped in the achievement of better and quicker target caloric intake.

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