Analysis of nutritional status and influence factors in PICU children with mechanical ventilation / 中国小儿急救医学

ABSTRACT

Objective To investigate the nutritional status of children with mechanical ventilation, explore the influencing factors of nutritional status,and provide a basis for clinical nutrition support for chil-dren with mechanical ventilation. Methods The children with mechanical ventilation who had ventilated for more than 5 days during the period from February 1,2017 to October 31,2017 were selected as subjects. Ac-cording to the mechanical ventilation time,they were divided into group A (5-16 d) and group B (17-29 d). We assessed malnutrition,screened nutritional risk,and measured albumin both on the admission and with-drawal of the ventilator, respectively. We also calculated the average caloric intake value (EI) and fluid vol-ume during mechanical ventilation. Measured resting energy expenditure (MREE)was calculated by using the Schofield-HTWT formula. Feeding status during mechanical ventilation was assessed by average EI/MREE. Results The incidence of malnutrition at admission was 36. 1%(13/36),and the incidence of malnutrition was 55. 6%(20/36) when evacuated from the ventilator. There was a significant difference(P<0. 05). The incidence of malnutrition was similar in group A and group B on admission,but the incidence of malnutrition in group B(62. 5%) was significantly higher than that in group A (53. 6%) when weaning. The average cal-orie in group B[(32. 25 ± 7. 36)kcal/(kg·d)]was significantly lower than that in group A[(40. 11 ± 6. 00) kcal/(kg·d)]. The mechanical ventilation time of group B[(540. 63 ± 89. 66) h] was significantly longer than that of group A[(224. 46 ± 64. 06)h](P<0. 05). Conclusion Children with mechanical ventilation in the PICU have a higher incidence of malnutrition and the nutritional status deteriorates further during hospital-ization,which may be related to calorie supply,duration of mechanical ventilation,fluid volume,and primary disease.