• Lyvonne Tume, Lynne Latten, and Andy Darbyshire.
• PICU, Alder Hey Children's NHS Foundation Trust, Liverpool, UK. l.tume@ljmu.ac.uk
• Nurs Crit Care. 2010 Nov 1;15(6):291-9.

BackgroundEstablishing and sustaining enteral feeding in critically ill children is challenging and has met with many problems.Aims And ObjectivesThe aim of this study was to investigate (a) how actual calorie intake compared with estimated caloric requirements and (b) whether feeding guideline adherence resulted in improved nutritional intake.Design And MethodsA prospective observational study was undertaken over 1 month in a tertiary referral paediatric intensive care unit (PICU) in the northwest of England.ResultsForty-seven children were studied, with a wide range of diagnoses in a 1-month period. Only 47% of the children had enteral feeds started within our 6 h post-admission target. Over half (55%) of the children received less than half of their estimated calorie requirements, but if feeding guidelines were followed, this resulted in a significantly higher (p = 0.004) delivery of the child's estimated requirements.ConclusionsThis study found that many children are not receiving adequate nutrition in PICU and that the use of feeding guidelines significantly improves calorie delivery in PICU patients.Relevance To Clinical PracticeThis paper highlights the dearth of research related to enteral feeding in critically ill children. We found that the use of feeding guidelines improved calorie delivery and so units should be encouraged to develop their own guidelines based on the best evidence available.© 2010 The Authors. Nursing in Critical Care © 2010 British Association of Critical Care Nurses.

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