A review of feeding intolerance in critically ill children

Tume, LN; Valla, FV

Abstract

Ensuring optimal nutrition is vital in critically ill children and enteral feeding is the main route of delivery in intensive care.
Feeding intolerance is the most commonly cited reason amongst pediatric intensive care unit healthcare professionals for
stopping or withholding enteral nutrition, yet the definition for this remains inconsistent, nebulous, and entirely arbitrary. Not
only does this pose problems clinically, but research in this field frequently uses feeding intolerance as an endpoint and the
heterogeneity in this definition makes the comparison of studies difficult and meta-analysis impossible.We reviewed the use of,
and definitions of, the term feed intolerance in pediatric intensive care research papers in the last 20 years. Gastric residual volume
remains the most common factor used to define feed intolerance, despite the lack of evidence for this. Healthcare professionals
would benefit from further education to improve their awareness of the limitations of the markers to define feeding intolerance,
and the international PICU community needs to agree a consistent definition of this phenomenon to improve consistency in both
practice and research.
Conclusion: This paper will provide a narrative review of the definitions of, evidence for, and markers of feeding intolerance in
critically ill children.

Citation

Tume, L., & Valla, F. (2018). A review of feeding intolerance in critically ill children. European Journal of Pediatrics, 177, 1675-1683. https://doi.org/10.1007/s00431-018-3229-4

• Journal Article Type: Article
• Acceptance Date: Aug 10, 2018
• Online Publication Date: Aug 17, 2018
• Publication Date: Nov 1, 2018
• Deposit Date: Sep 4, 2019
• Publicly Available Date: Sep 4, 2019
• Journal: European Journal of Pediatrics
• Print ISSN: 0340-6199
• Electronic ISSN: 1432-1076
• Publisher: Springer Verlag
• Volume: 177
• Pages: 1675-1683
• DOI: https://doi.org/10.1007/s00431-018-3229-4
• Publisher URL: https://doi.org/10.1007/s00431-018-3229-4
• Related Public URLs: https://link.springer.com/journal/431