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Pediatr Crit Care Me · Aug 2019
Observational StudyNutritional Status Deterioration Occurs Frequently During Children's ICU Stay.
- Frédéric V Valla, Florent Baudin, Bénédicte Gaillard Le Roux, Carole Ford-Chessel, Elodie Gervet, Céline Giraud, Tiphanie Ginhoux, Fleur Cour-Andlauer, Etienne Javouhey, and Lyvonne Tume.
- Pediatric Intensive Care, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, 59 bd Pinel 69500 Lyon-Bron, France.
- Pediatr Crit Care Me. 2019 Aug 1; 20 (8): 714-721.
ObjectivesMalnutrition 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.DesignSingle-center prospective observational study.SettingTwenty-three-bed general PICU, Lyon, France.PatientsAll critically ill children 0-18 years old with length of stay longer than 5 days were included (September 2013-December 2015).InterventionsWeight 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 ResultsWe 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.ConclusionsNutritional 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.
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