• Nutrition · Feb 2024

    Observational Study

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

    • Jacinta Winderlich, Bridget Little, Felix Oberender, Tessa Bollard, Tamara Farrell, Samantha Jenkins, Emma Landorf, Andrea McCall, Jessica Menzies, Katie O'Brien, Carla Rowe, Kirsten Sim, Melanie van der Wilk, Jemma Woodgate, Eldho Paul, Andrew A Udy, and Emma J Ridley.
    • Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Nutrition and Dietetics, Monash Children's Hospital, Melbourne, Australia; Paediatric Intensive Care Unit, Monash Children's Hospital, Melbourne, Australia. Electronic address: jacinta.winderlich@monash.edu.
    • Nutrition. 2024 Feb 1; 118: 112261112261.

    ObjectivesThe main aim of this study was to describe nutrition provision in Australian and New Zealand (ANZ) pediatric intensive care units (PICUs), including mode of nutrition and adequacy of enteral nutrition (EN) to PICU day 28. Secondary aims were to determine the proportion of children undergoing dietetics assessment, the average time to this intervention, and the methods for estimation of energy and protein requirements.MethodsThis observational study was conducted in all ANZ tertiary-affiliated specialist PICUs. All children ≤18 y of age admitted to the PICU over a 2-wk period and remaining for ≥48 h were included. Data were collected on days 1 to 7, 14, 21, and 28 (unless discharged prior). Data points included oral intake, EN and parenteral nutrition support, estimated energy and protein adequacy, and dietetics assessment details.ResultsWe enrolled 141 children, of which 79 were boys (56%) and 84 were <2 y of age (60%). Thirty children (73%) received solely EN on day 7 with documented energy and protein targets for 22 (73%). Of these children, 14 (64%) received <75% of their estimated requirements. A dietetics assessment was provided to 80 children (57%), and was significantly higher in those remaining in the PICU beyond the median length of stay (41% in patients staying ≤4.6 d versus 72% in those staying >4.6 d; P < 0.001).ConclusionsThis prospective study of nutrition provision across ANZ PICUs identified important areas for improvement, particularly in EN adequacy and nutrition assessment. Further research to optimize nutrition provision in this setting is urgently needed.Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.

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