NUTRI-REAPED study: nutritional assessment of French critically ill children and nutrition practice survey in French-speaking pediatric intensive care units

Jacquot, Aur�lien; Valla, Fr�d�ric Victor; Mura, Thibault; Tume, Lyvonne Nicole; Bertet, H�l�na; Ford-Chessel, Carole; Milesi, Christophe; Cambonie, Gilles; De Luca, Arnaud; Gaillard-Le Roux, B�n�dicte

Abstract

© 2019, The Author(s). Background: Impaired nutritional status is adversely associated with suboptimal outcomes in critically ill children. Undernutrition at pediatric intensive care unit (PICU) admission ranges from 15 to 65%. A lack of knowledge of the nutritional status of children in French PICUs prevents us from specifically targeting education. This study aims to describe the nutritional status of children in French PICUs and to assess nutritional practices and physicians’ knowledge of nutrition, in order to focus NutriSIP (the French-speaking PICU nutrition group) future education programs. A prospective observational multicenter point prevalence study was conducted in French PICUs, recruiting all children admitted over three different weeks. Anthropometric measurements were taken (weight, height/length, mid-upper arm, and head circumferences), in order to calculate nutritional indices. Nutritional status was defined according to WHO Body Mass Index z-score and dynamic assessment based on growth faltering detection. Concurrently, PICU physicians and PICU nurses from seven French-speaking countries completed a survey to ascertain knowledge about local nutritional care practices and overall nutrition knowledge. PICU physicians’ responses were compared to PICU nurses’ responses (previously published). Results: Four hundred and thirty-two children were included in the observational study from 27 French PICUs. Undernutrition was diagnosed in 18.5% of them, young age and underlying chronic condition being the two independent risk factors. Faltering growth was diagnosed in 4.8% and overweight in 7.4%. Subjective nutritional assessment was not accurate. Thirty-eight French-speaking PICUs completed the survey. These showed nutritional practices frequently did not comply with international guidelines, especially regarding nutritional goals, and the reasons for withholding enteral nutrition. Comparison between physicians’ and nurses’ responses to the survey showed large discrepancies. Conclusion: Undernutrition is frequent at admission in French PICUs. Nutritional status should be assessed using a holistic approach, because of the potential impact on outcome. French-speaking PICU healthcare professionals need further nutrition education, in order to improve nutritional practices to comply with international recommendations. This study will serve as a baseline to focus NutriSIP teaching programs in the future.

Citation

Jacquot, A., Valla, F. V., Mura, T., Tume, L. N., Bertet, H., Ford-Chessel, C., …Gaillard-Le Roux, B. (2019). NUTRI-REAPED study: nutritional assessment of French critically ill children and nutrition practice survey in French-speaking pediatric intensive care units. Annals of Intensive Care, 9(1), Article 15. https://doi.org/10.1186/s13613-019-0493-z

• Journal Article Type: Article
• Acceptance Date: Dec 12, 2018
• Online Publication Date: Jan 22, 2019
• Publication Date: Dec 1, 2019
• Deposit Date: Jan 24, 2019
• Publicly Available Date: Jan 24, 2019
• Journal: Annals of Intensive Care
• Electronic ISSN: 2110-5820
• Publisher: BioMed Central
• Peer Reviewed: Peer Reviewed
• Volume: 9
• Issue: 1
• Article Number: 15
• DOI: https://doi.org/10.1186/s13613-019-0493-z
• Keywords: nutrition, practices, pediatric intensive care
• Public URL: https://uwe-repository.worktribe.com/output/853465
• Publisher URL: https://doi.org/10.1186/s13613-019-0493-z