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Problems With Optimal Energy and Protein Delivery in the Pediatric Intensive Care Unit
Author(s) -
Moreno Yara M. F.,
Hauschild Daniela B.,
Barbosa Eliana,
Bresolin Nilzete L.,
Mehta Nilesh M.
Publication year - 2016
Publication title -
nutrition in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.725
H-Index - 71
eISSN - 1941-2452
pISSN - 0884-5336
DOI - 10.1177/0884533616639125
Subject(s) - medicine , interquartile range , medical prescription , pediatric intensive care unit , demographics , intensive care unit , resting energy expenditure , cohort , prospective cohort study , pediatrics , energy requirement , energy expenditure , emergency medicine , intensive care medicine , demography , nursing , psychology , sociology , regression , psychoanalysis
Background: Optimal nutrition therapy (NT) delivery is associated with improved outcomes in critically ill children. However, avoidable barriers impede delivery of optimal energy and protein in the pediatric intensive care unit (PICU). This study aims to describe the gap between energy and protein prescription and actual intake. Methods: Single‐center prospective cohort study, including consecutive children (age: 1 month to 15 years) admitted to the PICU in southern Brazil. Demographics, clinical characteristics, and NT details were recorded. Results: We enrolled 130 patients: 37% female; median (interquartile range) age, 29.43 months (4.03, 100.63); PICU length of stay, 6 days (4, 13). Median predicted energy expenditure by Schofield equation and prescribed and actual energy intake were 47.13 kcal/kg/d (38.60, 55.38), 31.94 kcal/kg/d (13.99, 51.90), and 25.06 kcal/kg/d (10.21, 46.92), respectively. On average, actual energy intake was 47% of the predicted energy expenditure, and 68% of patients were underfed. Actual protein intake was 49% of the estimated requirement. NT was interrupted in 64% of patients. Conclusions: There were significant gaps among the predicted requirement, prescription, and actual delivery of energy and protein in the PICU. Suboptimal prescription and multiple feeding interruptions resulted in underfeeding.