Abstract

CAPRA, Daniel R et al. Nutrición enteral precoz en pacientes pediátricos ventilados. Arch. argent. pediatr. [online]. 2006, vol.104, n.2, pp.133-137. ISSN 0325-0075.

Introduction. Nutrition in critical pediatric patients should be considered in the therapeutic strategy since admission. After the stabilization of the patient, and with a functional gastrointestinal tract, enteral nutrition should be started. Early enteral nutrition was defined as that provided within the first 24 hours. Objectives. 1) To assess if early enteral nutrition is feasible in ventilated pediatric patients and if it is possible to achieve adequate caloric and protein intake at the fourth day, according to nutritional objectives. 2) To correlate the response to early enteral nutrition with different diagnoses al admission. Population, materials and methods. This is an observational, prospective-descriptive study performed between 01/jan/2001 and 31/dec/2001. All ventilated patients during the first 24 h of admission to PICU were included. Exclusion criteria: Deceased within 24 h of admission to PICU; non-functioning gastrointestinal tract during the same period; those cases where caloric and protein intake could not be evaluated at the 4^th day. Patients were allocated in 4 age groups: 1 month-1 year; 1-5 years; 5-10 years; older than 10 years. Early enteral nutrition was considered successful when it was well tolerated during the first 24 h and protein and caloric goals were achieved at the 4th day. Results. Overall study population was 107 patients, 60 were male. Age median 6, month 1 month-1 year group: 79/107 (74%); of those, 71/79 (90%) had adequate caloric intake and 53/79 (67%) protein intake at the 4^th day. Figures for other groups were: 1-5 years: 24/107 (22%), 23/24 (96%) for adequate caloric intake and 24/24 (100%) for adequate protein intake. 5-10 years: 3/107 (3%), 2/3 (67%) for both adequate caloric and protein intakes. Older than 10 years: 1/107 (< 1%), with a successful early enteral nutrition. 84/107 (78%) had respiratory disease and adequate caloric intake was accomplished in 72/84 (86%) and adequate protein intake in 58/84 (69%). External injuries: 8/107 (7%), with adequate caloric and adequate protein intakes in 7/8 (87%). Neurological disease: 7/107 (6%), all achieved adequate caloric and adequate protein intakes. Shock: 4/107 (4%), with adequate caloric intake in 4/4 (100%) and adequate protein intake in 1/4 (25%). Malignant disease: 2/107 (2%) and miscellaneous 2/107 (2%). Conclusions. Early enteral nutrition was feasible in our ventilated pediatric patients. Adequate caloric intake and adequate protein intake were achieved in the majority of respiratory patients. The small number of patients in the other groups precludes any definite conclusion.

Keywords : Critical pediatric patient; Intragastric nutrition; Adequate caloric and protein intake.

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