ABSTRACT
Objective:To investigate the causes of enteral nutrition interruption in pediatric intensive care unit and its relationship with prognosis.Methods:In this retrospective study, 471 critically ill children admitted to PICU of Shengjing Hospital of China Medical University from January to June 2019 were enrolled.Data were collected to describe the patient cohort(anthropometrics and diagnostic category) and nutrition practices(feeding mode, frequency, duration, and causes of feeding interruptions). The effect of nutritional interruption on the prognosis of children was statistically analyzed.Results:Ninety-four patients(20.0%) had moderate malnutrition at PICU admission, fifty-eight patients(12.3%) had severe malnutrition.The nutritional deterioration rate was 3.8%(18 cases). The average weight loss during hospitalization was -0.14 kg.A total of 181(38.4%) patients had feeding interruption(FI) during hospitalization.There were 362 episodes of FI in total, with a median of two episodes per patient.Median duration of each episode was 14.89 h. The most common cause of FI was feeding intolerance( n=158, 43.6%). There were 270 episodes of FI in children feeded with milk powder.Median energy deficits per episode was -56.53 kcal/kg.There was no significant difference regarding the duration of FI among children with different diseases, different ages and different critical scores.Children with FI had significantly longer length of hospitalization, more hospitalization costs, greater length of mechanical ventilation and greater loss of weight( P<0.05, respectively). Conclusion:Enteral nutrition interruption is very common in PICU, and FI is the main reason.Nutrition interruption will reduce energy intake, which can prolong the period of hospitalization and mechanical ventilation, increase the hospitalization cost and the weight loss.
ABSTRACT
The gastrointestinal tract is the most vulnerable organ to infection, trauma, shock and other stress states.The incidence of gastrointestinal failure is high, which seriously affects the prognosis of critically ill children, but it lacks clear diagnostic indicators for clinical application.The intestinal blood supply mainly comes from superior mesenteric artery, so the blood perfusion of superior mesenteric artery can reflect the intestinal circulation.Based on the latest progress of gastrointestinal failure all over the world, and the extensive application of near infrared spectroscopy in brain and gastrointestinal tract, this study puts forward a powerful clinical index for the diagnosis of gastrointestinal failure-mesenteric local tissue oxygen saturation.