Peptide nutrient-energy dense enteral feeding in critically ill infants: an observational study
Peptide nutrient-energy dense enteral feeding in critically ill infants: an observational study
Background: Enteral feeding is challenging in critically ill infants. Target intakes are often not achieved as a result of fluid restriction, procedural interruptions and perceived enteral feeding intolerance. In those infants perceived to have poor feeding tolerance, the use of a peptide nutrient-energy dense enteral feed (PEF) may improve nutritional intake and minimise feeding interruptions as a result of gastrointestinal symptoms. The aim of this observational study was to characterise the use of a PEF amongst critically ill infants in two paediatric intensive care units (PICUs). Methods: Records from critically ill infants aged <12 months admitted to two PICUs were retrospectively reviewed with a PICU length of stay (LOS) ≥ 7 days. Achievement of nutritional targets for the duration of PEF was reviewed. Gastrointestinal symptoms, including gastric residual volume, constipation and vomiting, were evaluated as tolerance parameters. Results: In total, 53 infants were included, with a median age on admission of 2.6 months. Median admission weight was 3.9 kg in PICU-1 and 4.7 kg in PICU-2. Median (interquatile range) energy intake in PICU-1 and PICU-2 was 68 (47–92) and 90 (63–124) kcal kg−1, respectively, and median (interquatile range) protein intake 1.7 (1.1–2.4) g kg−1 and 2.5 (1.6–3.2) g kg−1, respectively. Feeding was withheld because of feeding intolerance in one infant (4%) on two occasions in PICU-1 for 2.5 h and in two infants (7%) on two occasions in PICU-2 for 19.5 h. Gastric residual mean (SD) volumes were 3.5 (5.4) mL kg−1 in PICU-1 and 16.9 (15.6) mL kg−1 in PICU-2. Conclusions: Peptide nutrient-energy dense feeding in infants admitted to the PICU is feasible, well tolerated and nutritional targets are met. However, with this study design, it is not possible to draw any conclusions regarding the benefit of PEF over standard PE feed in critically ill children and future work is required to clarify this further.
critical illness, hydrolysed enteral feeds, infants, semi-elemental
400-408
Marino, L.V.
c479400f-9424-4879-9ca6-d81e6351de26
Eveleens, R.D.
6e6d8ebb-c062-4556-af8b-cb2fcf55e99c
Morton, K.
a7987556-bf8a-489e-ab03-ded05892b0ef
Verbruggen, S.C.A.T.
f49e7802-0a44-406b-8d3d-c9d31a941038
Joosten, K.F.M.
abe9b92c-7e88-4c4c-ba48-411548953ea2
June 2019
Marino, L.V.
c479400f-9424-4879-9ca6-d81e6351de26
Eveleens, R.D.
6e6d8ebb-c062-4556-af8b-cb2fcf55e99c
Morton, K.
a7987556-bf8a-489e-ab03-ded05892b0ef
Verbruggen, S.C.A.T.
f49e7802-0a44-406b-8d3d-c9d31a941038
Joosten, K.F.M.
abe9b92c-7e88-4c4c-ba48-411548953ea2
Marino, L.V., Eveleens, R.D., Morton, K., Verbruggen, S.C.A.T. and Joosten, K.F.M.
(2019)
Peptide nutrient-energy dense enteral feeding in critically ill infants: an observational study.
Journal of Human Nutrition and Dietetics, 32 (3), .
(doi:10.1111/jhn.12645).
Abstract
Background: Enteral feeding is challenging in critically ill infants. Target intakes are often not achieved as a result of fluid restriction, procedural interruptions and perceived enteral feeding intolerance. In those infants perceived to have poor feeding tolerance, the use of a peptide nutrient-energy dense enteral feed (PEF) may improve nutritional intake and minimise feeding interruptions as a result of gastrointestinal symptoms. The aim of this observational study was to characterise the use of a PEF amongst critically ill infants in two paediatric intensive care units (PICUs). Methods: Records from critically ill infants aged <12 months admitted to two PICUs were retrospectively reviewed with a PICU length of stay (LOS) ≥ 7 days. Achievement of nutritional targets for the duration of PEF was reviewed. Gastrointestinal symptoms, including gastric residual volume, constipation and vomiting, were evaluated as tolerance parameters. Results: In total, 53 infants were included, with a median age on admission of 2.6 months. Median admission weight was 3.9 kg in PICU-1 and 4.7 kg in PICU-2. Median (interquatile range) energy intake in PICU-1 and PICU-2 was 68 (47–92) and 90 (63–124) kcal kg−1, respectively, and median (interquatile range) protein intake 1.7 (1.1–2.4) g kg−1 and 2.5 (1.6–3.2) g kg−1, respectively. Feeding was withheld because of feeding intolerance in one infant (4%) on two occasions in PICU-1 for 2.5 h and in two infants (7%) on two occasions in PICU-2 for 19.5 h. Gastric residual mean (SD) volumes were 3.5 (5.4) mL kg−1 in PICU-1 and 16.9 (15.6) mL kg−1 in PICU-2. Conclusions: Peptide nutrient-energy dense feeding in infants admitted to the PICU is feasible, well tolerated and nutritional targets are met. However, with this study design, it is not possible to draw any conclusions regarding the benefit of PEF over standard PE feed in critically ill children and future work is required to clarify this further.
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e-pub ahead of print date: 8 March 2019
Published date: June 2019
Keywords:
critical illness, hydrolysed enteral feeds, infants, semi-elemental
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Local EPrints ID: 431941
URI: http://eprints.soton.ac.uk/id/eprint/431941
ISSN: 0952-3871
PURE UUID: 7d02e520-0928-4503-81af-4e28a425b975
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Date deposited: 21 Jun 2019 16:30
Last modified: 16 Mar 2024 01:06
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Contributors
Author:
L.V. Marino
Author:
R.D. Eveleens
Author:
K. Morton
Author:
S.C.A.T. Verbruggen
Author:
K.F.M. Joosten
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