Enteral feeding of children on noninvasive respiratory support : a four-centre European study

Tume, LN ORCID: https://orcid.org/0000-0002-2547-8209, Eveleens, R, Mayordomo-Colunga, J, Lopez, J, Verbruggen, S, Fricaudet, M, Smith, C, Garcia Cusco, M, Latten, L and Valla, FV 2021, 'Enteral feeding of children on noninvasive respiratory support : a four-centre European study' , Pediatric Critical Care Medicine, 22 (3) , e192-e202.

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Objective: To explore enteral feeding practices and the achievement of energy targets in children on Non-invasive respiratory support (NRS), in four European Pediatric Intensive Care Units (PICUs). Design: A four centre retrospective cohort study Setting: Four PICUs: Bristol UK, Lyon France, Madrid Spain, Rotterdam the Netherlands. Patients: Children in PICU who required acute NRS in the first 7 days. The primary outcome was achievement of standardised kcal/goal. Interventions: Nil Measurements and Main Results: 325 children were included (Bristol 104; Lyon 99; Madrid 72; Rotterdam 50). The median (IQR) age and weight were 3 months (1-16) and 5 Kg (4-10) respectively, with 66% admitted with respiratory failure. There were large between-centre variations in practices. Overall, 190/325 (58.5%) received NRS in order to prevent intubation and 41.5% after extubation. The main modes of NRS used were high-flow nasal cannula 43.6%, bilevel positive airway pressure 33.2% and continuous positive airway pressure 21.2% Most children (77.8%) were fed gastrically (48.4% continuously) and the median time to first feed after NRS initiation was 4 hours (IQR 1-9). The median percentage of time a child was nil per oral whilst on NRS was 4 hours (2-13). Overall, children received a median of 56% (25%-82%) of their energy goals compared to a standardised target of 0.85 of the recommended dietary allowance. Patients receiving step-up NRS (p=<0.001), those on BLPAP or CPAP (compared to HFNC) (p =<0.001) and those on continuous feeds (p =<0.001) achieved significantly more of their kcal goal. GI complications varied from 4.8 – 20%, with the most common reported being vomiting in 54/325 (16.6%), other complications occurred in 40/325 (12.3%) children, but pulmonary aspiration was rare 5/325 (1.5%). Conclusions: Children on NRS tolerated feeding well, with relatively few complications, but prospective trials are now required to determine the optimal timing and feeding method for these children.

Item Type: Article
Schools: Schools > School of Health and Society > Centre for Health Sciences Research
Journal or Publication Title: Pediatric Critical Care Medicine
Publisher: Lippincott, Williams & Wilkins
ISSN: 1529-7535
Related URLs:
Depositing User: Dr Lyvonne Tume
Date Deposited: 01 Sep 2020 10:41
Last Modified: 15 Feb 2022 17:18
URI: http://usir.salford.ac.uk/id/eprint/58119

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