Nutrition provision in Australian and New Zealand PICUs: A prospective observational cohort study (ePICUre)

Winderlich, Jacinta; Little, Bridget; Oberender, Felix; Bollard, Tessa; Farrell, Tamara; Jenkins, Samantha; Landorf, Emma; McCall, Andrea; Menzies, Jessica; O'Brien, Katie; Rowe, Carla; Sim, Kirsten; van der Wilk, Melanie; Woodgate, Jemma; Paul, Eldho; Udy, Andrew A.; Ridley, Emma J.

doi:10.1016/j.nut.2023.112261

Nutrition

2024

DOI: 10.1016/j.nut.2023.112261

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Nutrition provision in Australian and New Zealand PICUs: A prospective observational cohort study (ePICUre)

Jacinta Winderlich,

Bridget Little,

Felix Oberender

et al.

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Characteristics of enteral and oral nutrition support among infants and young children in the pediatric intensive care unit: A descriptive cohort study

Winderlich,

Little,

Oberender

et al. 2024

J Parenter Enteral Nutr

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BackgroundChildren who are critically ill are often reliant on enteral and oral nutrition support. However, there is limited evidence to guide “what” to prescribe, and current practice is unknown. The primary objective of this study was to describe enteral nutrition prescription in children ≤2 years of age in the pediatric intensive care unit (PICU). The secondary objectives were to describe oral nutrition support practices and factors associated with the use of increased energy and protein density nutrition support.MethodsChildren ≤2 years of age admitted to participating PICUs over a 2‐week period in June 2021 were enrolled. Data were collected on PICU admission days 1 to 7, 14, 21, and 28 on the mode of nutrition, enteral and oral nutrition support prescription, and dietitian intervention.ResultsEighty‐four children were included (49 [58%] male; 79 [94%] ≤1 year of age). Enteral nutrition was administered to 79 (94%) children (with expressed breast milk in 45 [57%]). Forty‐three children received formula as enteral nutrition. Increased energy and protein density formulas were provided to 14 (33%) children enterally, with concentrated standard infant formula powder being the most common (5 [12%]). Among children offered oral intake (22; 26%), three (14%) received oral nutrition support. Children who received increased energy and protein density enteral nutrition were more likely to receive dietitian intervention (P = 0.002).ConclusionIn children ≤2 years of age admitted to PICU, expressed breast milk was provided to half of those requiring enteral nutrition and oral nutrition support prescription was infrequent. One third of children receiving formula via enteral nutrition received an increased energy and protein density feed, and this was strongly associated with dietitian intervention.

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Characteristics of enteral and oral nutrition support among infants and young children in the pediatric intensive care unit: A descriptive cohort study

Winderlich,

Little,

Oberender

et al. 2024

J Parenter Enteral Nutr

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Nutrition support in children discharged from the pediatric intensive care unit: A bi‐national prospective cohort study (ePICUre)

Winderlich,

Little,

Oberender

et al. 2024

J. pediatr. gastroenterol. nutr.

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ObjectivesThe role of nutrition in the recovery of critically ill children has not been investigated and current nutrition provision in the post‐pediatric intensive care unit (PICU) period is unknown. The primary objective of this study was to describe ward nutrition support in children following PICU discharge.MethodsChildren up to 18 years admitted to one of nine PICUs over a 2‐week period with a length of stay >48 h were enrolled. Data were collected on the first full ward day following PICU discharge and on Days 7, 14, 21, and 28 following PICU admission. Data points included oral intake, enteral (EN) and parenteral nutrition (PN) support, and oral and EN energy and protein provision.ResultsAmong the 108 children, on the first full ward day 75/108 (69%) children received EN, 54/108 (50%) oral intake, and 8/108 (7%) PN. Of those receiving oral nutrition only on the first full ward day (25/108; 23%), 9/25 (36%) received <50% of their estimated energy and protein requirements. Of those provided EN only, and where nutrition targets were known, on the first full ward day 8/46 (17%) and 7/46 (15%) met <75% of their estimated energy and protein requirements, respectively. On Day 28, this increased to 4/12 (33%) and 5/12 (42%).ConclusionsIn this study of ward‐based nutrition support, key findings included consistent use of EN and PN up to at least 28 days following PICU admission, and a high proportion of children receiving EN or oral intake only not meeting their estimated energy and protein requirements.

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Nutrition provision in Australian and New Zealand PICUs: A prospective observational cohort study (ePICUre)

Cited by 2 publications

References 20 publications

Characteristics of enteral and oral nutrition support among infants and young children in the pediatric intensive care unit: A descriptive cohort study

Characteristics of enteral and oral nutrition support among infants and young children in the pediatric intensive care unit: A descriptive cohort study

Nutrition support in children discharged from the pediatric intensive care unit: A bi‐national prospective cohort study (ePICUre)

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