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Avoidable Causes of Delayed Enteral Nutrition in Critically Ill Children

Authors
 Hosun Lee  ;  Shin Ok Koh  ;  Hyungmi Kim  ;  Myung Hyun Sohn  ;  Kyu-Earn Kim  ;  Kyung Won Kim 
Citation
 JOURNAL OF KOREAN MEDICAL SCIENCE, Vol.28(7) : 1055-1059, 2013 
Journal Title
JOURNAL OF KOREAN MEDICAL SCIENCE
ISSN
 1011-8934 
Issue Date
2013
MeSH
Adolescent ; Child ; Child, Preschool ; Critical Illness ; Energy Intake ; Enteral Nutrition/statistics & numerical data* ; Female ; Gastrointestinal Hemorrhage/diagnosis* ; Gastrointestinal Motility ; Humans ; Ileus/diagnosis* ; Infant ; Intensive Care Units ; Male ; Nutritional Status ; Retrospective Studies ; Treatment Outcome ; Withholding Treatment/statistics & numerical data*
Keywords
Child ; Critical Illness ; Enteral Nutrition ; Parenteral Nutrition
Abstract
To evaluate the incidence of delayed enteral nutrition (EN) and identify avoidable causes of delay, we retrospectively reviewed medical records of 200 children (median age [range]; 37.5 [1-216] months) who stayed in the intensive care unit (ICU) for a minimum of 3 days. Among 200 children, 115 received EN following ICU admission with a median time of EN initiation of 5 days after admission. Of these, only 22 patients achieved the estimated energy requirement. A significant decrease in the final z score of weight for age from the initial assessment was observed in the non-EN group only (-1.3±2.17 to -1.57±2.35, P<0.001). More survivors than non-survivors received EN during their ICU stay (61.2% vs 30.0%, P=0.001) and received EN within 72 hr of ICU admission (19.8% vs 3.3%, P=0.033). The most common reason for delayed EN was gastrointestinal (GI) bleeding, followed by altered GI motility and hemodynamic instability. Only eight cases of GI bleeding and one case of altered GI motility were diagnosed as active GI bleeding and ileus, respectively. This study showed that the strategies to reduce avoidable withholding EN are necessary to improve the nutrition status of critically ill children.
Files in This Item:
T201302256.pdf Download
DOI
10.3346/jkms.2013.28.7.1055
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아과학교실) > 1. Journal Papers
Yonsei Authors
Koh, Shin Ok(고신옥)
Kim, Kyung Won(김경원) ORCID logo https://orcid.org/0000-0003-4529-6135
Kim, Kyu Earn(김규언)
Sohn, Myung Hyun(손명현) ORCID logo https://orcid.org/0000-0002-2478-487X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/87222
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