Nutritional status deterioration occurs frequently during childrens’ intensive care unit stay

Valla, Fr�d�ric V.; Baudin, Florent; Gaillard Le Roux, B�n�dicte; Ford-Chessel, Carole; Gervet, Elodie; Giraud, C�line; Ginhoux, Tiphanie; Cour-Andlauer, Fleur; Javouhey, Etienne; Tume, Lyvonne

Abstract

OBJECTIVES: Malnutrition and faltering growth at PICU admission have been related to suboptimal outcomes. However, little is known about nutritional status deterioration during PICU stay, as critical illness is characterized by a profound and complex metabolism shift, which affects energy requirements and protein turnover. We aim to describe faltering growth occurrence during PICU stay. DESIGN: Single-center prospective observational study. SETTING: Twenty-three-bed general PICU, Lyon, France. PATIENTS: All critically ill children 0-18 years old with length of stay longer than 5 days were included (September 2013-December 2015). INTERVENTIONS: Weight and height/length were measured at admission, and weight was monitored during PICU stay, in order to calculate body mass index for age z score. Faltering growth was defined as body mass index z score decline over PICU stay. Children admitted during the first year of the study and who presented with faltering growth were followed after PICU discharge for 3 months. MEASUREMENTS AND MAIN RESULTS: We analyzed 579 admissions. Of them, 10.2% presented a body mass index z score decline greater than 1 SD and 27.8% greater than 0.5. Admission severity risk scores and prolonged PICU stay accounted for 4% of the variability in nutritional status deterioration. Follow-up of post-PICU discharge nutritional status showed recovery within 3 months in most patients. CONCLUSIONS: Nutritional deterioration is frequent and often intense in critically ill children with length of stay greater than 5 days. Future research should focus on how targeted nutritional therapies can minimize PICU faltering growth and improve post-PICU rehabilitation.

• Journal Article Type: Article
• Acceptance Date: Feb 22, 2019
• Online Publication Date: Aug 1, 2019
• Publication Date: Aug 1, 2019
• Deposit Date: Feb 25, 2019
• Publicly Available Date: Aug 2, 2020
• Journal: Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
• Print ISSN: 1529-7535
• Publisher: Lippincott, Williams & Wilkins
• Peer Reviewed: Peer Reviewed
• Volume: 20
• Issue: 8
• Pages: 714-721
• DOI: https://doi.org/10.1097/PCC.0000000000001979
• Keywords: child, pediatric, intensive care, nutrition, outcomes
• Public URL: https://uwe-repository.worktribe.com/output/851925
• Publisher URL: https://journals.lww.com/pccmjournal/pages/default.aspx
• Contract Date: Feb 25, 2019