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

Valla, Frédéric V.; Baudin, Florent; Gaillard Le Roux, Bénédicte; Ford-Chessel, Carole; Gervet, Elodie; Giraud, Céline; Ginhoux, Tiphanie; Cour-Andlauer, Fleur; Javouhey, Etienne; Tume, Lyvonne

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Authors

Frédéric V. Valla

Florent Baudin

Bénédicte Gaillard Le Roux

Carole Ford-Chessel

Elodie Gervet

Céline Giraud

Tiphanie Ginhoux

Fleur Cour-Andlauer

Etienne Javouhey

Lyvonne Tume Lyvonne.Tume@uwe.ac.uk
Associate Professor in Child Health



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.

Citation

Valla, F. V., Baudin, F., Gaillard Le Roux, B., Ford-Chessel, C., Gervet, E., Giraud, C., …Tume, L. (2019). Nutritional status deterioration occurs frequently during childrens’ intensive care unit stay. Pediatric Critical Care Medicine, 20(8), 714-721. https://doi.org/10.1097/PCC.0000000000001979

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

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Copyright Statement
This is the accepted version of the paper. The published version can be found at https://doi.org/10.1097/PCC.0000000000001979








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