Reducing malnutrition in critically ill pediatric patients

Costa, Caroline Abud Drumond; García, Pedro Celiny Ramos; Cabral, Daiane Drescher; Tonial, Cristian Tedesco; Bruno, Francisco; Enloft, Paulo Roberto; Velozo, Kelly Daiane Stochero

doi:10.5935/0103-507x.20180034

Cited by 5 publications

(3 citation statements)

References 25 publications

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“…The forest plot was described as having UN cases significantly decreased mortality incidence in two studies ( 27 , 37 ), while four out of eleven studies described increased significance in mortality incidence on UN children, which was between 3 and 18 percentiles ( 24 , 28 , 30 , 33 ); for more details, refer to Figure 2A .…”

Section: Resultsmentioning

confidence: 99%

“…However, we cannot rely on this result as the heterogeneity was high. Therefore, we excluded studies with a non-significant result to test the sensitivity analysis, which were studies by Leite et al ( 23 ), Ward et al ( 27 ), Anton-Martin et al ( 30 ), Costa et al ( 28 ), and Xiong et al ( 37 ). Surprisingly, we found that mortality incidence in UN PICU was 5% higher than in the NN on a homogeneous sample.…”

Section: Discussionmentioning

confidence: 99%

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Is Undernutrition Associated With Deterioration of Outcomes in the Pediatric Intensive Care Unit (PICU): Systematic and Meta-Analysis Review

Albadi

Bookari

2022

Front. Pediatr.

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Background and aimUndernutrition (UN) may negatively impact clinical outcomes for hospitalized patients. The relationship between UN status at pediatric intensive care unit (PICU) admission and clinical outcomes is still not well-reported. This systematic meta-analysis review evaluated the impact of UN at admission to PICU on clinical outcomes, including mortality incidence, length of stay (LOS), and the need for and length of time on mechanical ventilation (MV).MethodsA search was conducted using relevant and multi-medical databases from inception until January 2022. We considered studies that examined the link between UN at PICU admission and clinical outcomes in patients aged 18 years or younger. Pooled risk difference estimates for the PICU outcomes were calculated using a random-effects model.ResultThere were a total of 10,638 patients included in 17 observational studies; 8,044 (75.61%) and 2,594 (24.38%) patients, respectively, were normal-nourished (NN) and undernourished (UN). In comparison to NN patients, UN patients had a slightly higher risk of mortality (RD = 0.02, P = 0.05), MV usage (RD = 0.05, P = 0.02), and PICU LOS (RD = 0.07, P = 0.007). While the duration of MV was significantly longer in UN than in NN (RD = 0.13, P < 0.0001). Sensitivity analysis of UN classification cohorts with a z-score < -2 or in the 5%, patetints age up to 18 years, and mixed diagnose for PICU admission demonstrated a 6-fold increase in the probability of PICU LOS in UN patients compared to NN patients (RD = 0.06, 95% CI = 0.01, 0.12). UN patients have a higher risk of MV usage RD = 0.07, 95% CI = 0.00, 0.14) in studies involving cohorts with a mixed primary diagnosis for PICU admission.ConclusionIn PICU, UN is linked to mortality incidence, longer PICU stay, MV usage, and duration on MV. The primary diagnosis for PICU admission may also influence clinical outcomes. Determining the prevalence of UN in hospitalized patients, as well as the subgroups of patients diagnosed at the time of admission, requires more research. This may help explain the relationship between nutritional status and clinical outcomes in PICU patients.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Is Undernutrition Associated With Deterioration of Outcomes in the Pediatric Intensive Care Unit (PICU): Systematic and Meta-Analysis Review

Albadi

Bookari

2022

Front. Pediatr.

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“…This is due to different reasons that limit the provision of ideal nutrition, such as volume restrictions, procedures and interventions, frequent food breaks and lack of standardization of evidence-based processes for better nourishment. The different types of conditions and disorders they present with also plays a role in increasing the nutritional requirements that expose the patient to metabolic stress further aggravating the malnutrition by placing them at a higher risk of developing organ dysfunctions and several morbidities [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

The prevalence of malnutrition during admission to the pediatric intensive care unit, a retrospective cross-sectional study at Tikur Anbessa Hospital, Addis Ababa, Ethiopia

Teka¹,

Kebede²,

Alpert³

2022

Pan Afr Med J

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Introduction malnutrition is a common problem in Ethiopia. Studies show malnourished children in intensive care units succumb more often to infection and death but Ethiopia has no available data to assess the prevalence of malnutrition in children admitted to pediatric Intensive Care Unit and their clinical patterns, this study was conducted to assess these variables in a tertiary hospital in Ethiopia. Methods this was a retrospective cross sectional study done on 243 children, ranging from 1 month to 15 years of age, from January 2016 to December 2018. Anthropometric interpretation was done using WHO Z score charts. The assessed outcome variables were death, length of stay in pediatric intensive care unit (PICU), days on mechanical ventilator and hospital acquired infection. Collected data was entered and analyzed using SPSS 20.0 version. Results the overall prevalence of wasting was 37.8% (n=92). Stunting was seen in 45.7% (n=111). Compared to well-nourished children, malnourished children were more likely to require mechanical ventilation (78.3% versus 66.2% OR-2, p=0.045), experience longer time on mechanical ventilation (10.3±13.2 days versus 6.1±7.9 days, p=0.012), develop hospital acquired infection (HAI) more often (30.4% versus 19.2%, p=0.045), and have a prolonged length of stay (10.7±16.4 days versus 6.1±8.4 days, p=0.005). Conclusion malnutrition in our PICU was identified to be a common cause of morbidity associated with greater need for mechanical ventilation, prolonged ventilator days, increased HAI, and longer hospital stays. Taking into consideration scarcity of resources, malnutrition imposes great burden on clinical care.

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Nutritional and clinical factors associated with acute kidney injury development in critically ill children

Ribeiro de Souza,

Piovezani,

Ventura

et al. 2023

J Nephrol

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Reducing malnutrition in critically ill pediatric patients

Cited by 5 publications

References 25 publications

Is Undernutrition Associated With Deterioration of Outcomes in the Pediatric Intensive Care Unit (PICU): Systematic and Meta-Analysis Review

Is Undernutrition Associated With Deterioration of Outcomes in the Pediatric Intensive Care Unit (PICU): Systematic and Meta-Analysis Review

The prevalence of malnutrition during admission to the pediatric intensive care unit, a retrospective cross-sectional study at Tikur Anbessa Hospital, Addis Ababa, Ethiopia

Nutritional and clinical factors associated with acute kidney injury development in critically ill children

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