Nutritional status deterioration occurs frequently during children's ICU stay

Valla, FV; Baudin, F; Gaillard Le Roux, B; Ford-Chessel, C; Gervet, E; Giraud, C; Ginhoux, T; Cour-Andlauer, F; Javouvey, E; Tume, LN

Abstract

OBJECTIVES:
Malnutrition and faltering growth at PICU admission have been related to suboptimal outcomes. However, little is known about nutritional status deterioration during PICU stay, as critical illness is characterized by a profound and complex metabolism shift, which affects energy requirements and protein turnover. We aim to describe faltering growth occurrence during PICU stay.
DESIGN:
Single-center prospective observational study.
SETTING:
Twenty-three-bed general PICU, Lyon, France.
PATIENTS:
All critically ill children 0-18 years old with length of stay longer than 5 days were included (September 2013-December 2015).
INTERVENTIONS:
Weight and height/length were measured at admission, and weight was monitored during PICU stay, in order to calculate body mass index for age z score. Faltering growth was defined as body mass index z score decline over PICU stay. Children admitted during the first year of the study and who presented with faltering growth were followed after PICU discharge for 3 months.
MEASUREMENTS AND MAIN RESULTS:
We analyzed 579 admissions. Of them, 10.2% presented a body mass index z score decline greater than 1 SD and 27.8% greater than 0.5. Admission severity risk scores and prolonged PICU stay accounted for 4% of the variability in nutritional status deterioration. Follow-up of post-PICU discharge nutritional status showed recovery within 3 months in most patients.
CONCLUSIONS:
Nutritional deterioration is frequent and often intense in critically ill children with length of stay greater than 5 days. Future research should focus on how targeted nutritional therapies can minimize PICU faltering growth and improve post-PICU rehabilitation.

Citation

Valla, F., Baudin, F., Gaillard Le Roux, B., Ford-Chessel, C., Gervet, E., Giraud, C., …Tume, L. (2019). Nutritional status deterioration occurs frequently during children's ICU stay. Pediatric Critical Care Medicine, 20(8), 714-721. https://doi.org/10.1097/PCC.0000000000001979

• Journal Article Type: Article
• Publication Date: Aug 1, 2019
• Deposit Date: Sep 11, 2019
• Journal: Pediatric Critical Care Medicine
• Print ISSN: 1529-7535
• Electronic ISSN: 1947-3893
• Publisher: Lippincott, Williams & Wilkins
• Volume: 20
• Issue: 8
• Pages: 714-721
• DOI: https://doi.org/10.1097/PCC.0000000000001979.
• Publisher URL: http://dx.doi.org/10.1097/PCC.0000000000001979
• Related Public URLs: https://journals.lww.com/pccmjournal/pages/default.aspx