• Enid E Martinez, Hongxing Dang, Jennifer Franks, Charles G Callif, Robert C Tasker, Kate Madden, and Nilesh M Mehta.
• Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA.
• Pediatr Crit Care Me. 2021 Dec 1; 22 (12): 108310871083-1087.

ObjectivesEnteral nutrition delivery is limited by intolerance and interruptions in critically ill children. Anticholinergic properties of frequently administered medications may contribute to altered gastric motility and enteral nutrition intolerance in this population. We examined the association between the anticholinergic burden of administered medications using the Anticholinergic Drug Scale and adequacy of enteral nutrition delivery.DesignSecondary analysis of data from a previously characterized PICU cohort.SettingMultidisciplinary PICU in a quaternary academic medical center.PatientsYounger than or equal to 18 years, on mechanical ventilation and received enteral nutrition within the first 3 days of PICU admission.Measurements And Main ResultsDaily Anticholinergic Drug Scale score, demographic data, and clinical data were obtained from the primary study. Percent enteral energy adequacy ([kcal delivered ÷ kcal prescribed] × 100) during the first 3 days of PICU admission was calculated. Forty-two patients received enteral nutrition, with median age (interquartile range) 5 years (1.09-12.54 yr), and 62% were male. Median Anticholinergic Drug Scale score was inversely correlated with energy adequacy, with a median 9% decline in energy adequacy per 1-point increase in Anticholinergic Drug Scale score (coefficient, -9.3; 95% CI, -13.43 to -5.27; R2 = 0.35; p < 0.0001). Median hours of enteral nutrition interruptions directly correlated with Anticholinergic Drug Scale score (coefficient, 1.5; 95% CI, 0.531-2.54; R2 = 0.19; p = 0.004). Severity score was greater in patients with less than or equal to 25% enteral energy adequacy and directly correlated with median Anticholinergic Drug Scale score.ConclusionsAnticholinergic burden from medications administered in the PICU is a potentially modifiable factor for suboptimal enteral nutrition delivery.Copyright © 2021 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

14 keywords...

hide…