Nutritional Status Deterioration Occurs Frequently During Children’s ICU Stay
Valla, Frédéric V., MD, MSc1,2; Baudin, Florent, MD, MSc1,3; Gaillard Le Roux, Bénédicte, MD4; Ford-Chessel, Carole, BD5; Gervet, Elodie, MD6; Giraud, Céline, MSc7; Ginhoux, Tiphanie, MSc8; Cour-Andlauer, Fleur, MD, MSc1; Javouhey, Etienne, MD, PhD1; Tume, Lyvonne, RN, PhD9,10
Pediatric Critical Care Medicine: May 31, 2019 - Volume Online First - Issue - p
doi: 10.1097/PCC.0000000000001979
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Abstract
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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.
©2019The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
Valla, Frédéric V., MD, MSc1,2; Baudin, Florent, MD, MSc1,3; Gaillard Le Roux, Bénédicte, MD4; Ford-Chessel, Carole, BD5; Gervet, Elodie, MD6; Giraud, Céline, MSc7; Ginhoux, Tiphanie, MSc8; Cour-Andlauer, Fleur, MD, MSc1; Javouhey, Etienne, MD, PhD1; Tume, Lyvonne, RN, PhD9,10
Pediatric Critical Care Medicine: May 31, 2019 - Volume Online First - Issue - p
doi: 10.1097/PCC.0000000000001979
Feature Article: PDF Only
BUY
SDC
PAP
Abstract
Author Information
Article Metrics
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.
©2019The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
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