P0259 / #2083: Does Early Enteral Nutrition in Children on Ecls Increase the Risk of Gastrointestinal Complications?

Odutolu, Y.; Shetty, Neeta; Nolan, S.; Brady, A. J.; Latten, Lynne; Tume, Lyvonne N.

doi:10.1097/01.pcc.0000739376.58270.41

Cited by 1 publication

(6 citation statements)

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“…All the studies had reliable nonexposed cohort and exposure ascertainment. Four studies did not evaluate the mortality outcome or deaths associated with EN 17,19,22,23 . Adjusted analysis was used for 4 studies, 12,13,21,24 and 10 studies had a reliable method of outcome ascertainment and adequate follow‐up length.…”

Section: Resultsmentioning

confidence: 99%

“…There was some variation in the nutrition management of the children who were included in these studies (Table 3). A total of nine studies initiated EN within 7 days of ECMO therapy 11–13,17,18,21,22,24,27 . One study had a median time to EN initiation of 23 h, 22 whereas four other studies started EN within 3 days 12,17,18,21 .…”

Section: Resultsmentioning

confidence: 99%

“…The median duration of ECMO in the 10 studies ranged from 5 to 10 days. 11,12,[17][18][19][20][22][23][24]26 Two studies showed no significant difference in the duration of ECMO assistance in EN and PN groups. 25,27…”

Section: Description Of Ecmo Indication and Treatmentmentioning

confidence: 97%

“…Four studies did not evaluate the mortality outcome or deaths associated with EN. 17,19,22,23 Adjusted analysis was used for 4 studies, 12,13,21,24 and 10 studies had a reliable method of outcome ascertainment and adequate follow-up length. One study had 2 patients who were loss to follow-up out of 16 total patients.…”

Section: Study Quality Assessmentmentioning

confidence: 99%

“…A total of nine studies initiated EN within 7 days of ECMO therapy. [11][12][13]17,18,21,22,24,27 One study had a median time to EN initiation of 23 h, 22 whereas four other studies started EN within 3 days. 12,17,18,21 In eight studies, the EN administration routes were gastric via oral or nasal tube, or postpyloric, 11,12,[18][19][20][23][24][25] but one study included children with gastrostomy.…”

Section: Description Of the Nutrition And Pharmacological Managementmentioning

confidence: 99%

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Enteral nutrition in children and adolescents who receive extracorporeal membrane oxygenation and its impact on complications and mortality: A systematic review and meta‐analysis

Li,

Fan,

Pan

et al. 2024

J Parenter Enteral Nutr

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Enteral nutrition (EN) is one method of nutrition support for children and adolescents receiving extracorporeal membrane oxygenation (ECMO) therapy, and there are no guidelines for its use in this population. We conducted a systematic review to determine whether EN is effective and safe in children supported by ECMO. We searched the Cochrane Library database, MEDLINE, and Embase on Ovid in March 2023 to identify studies that evaluated children and adolescents who received ECMO and were treated with EN. Random effects meta‐analysis was used to estimate the odds of mortality with EN compared with parenteral nutrition (PN). A total of 14 studies were included in this review with 1650 patients (796 received EN). The median duration of ECMO was 5–10 days, and the median EN initiation time ranged from 23 h to 7 days. The pooled results suggest no significant difference in mortality with EN compared with PN (odds ratio [OR] = 0.77; 95% CI, 0.56–1.05; I2 = 26%). Exclusion of the only study that reported an increase in mortality resulted in a borderline significant reduction in mortality with EN (OR = 0.71; 95% CI, 0.51–1.00; I2 = 26%). The predictors of EN were male sex, older age, heavier weight, greater height, cardiac diagnosis, longer duration of ECMO, and use of venovenous ECMO. Most studies suggest no correlation between EN and complications. EN use in children and adolescents who receive ECMO does not appear to be associated with increased mortality compared with PN and was safe in terms of intestinal complications and feeding intolerance.

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Section: Resultsmentioning

confidence: 99%