Nutritional Status Deterioration Occurs Frequently during Children's ICU Stay

Frédéric V. Valla*, Florent Baudin, Bénédicte Gaillard Le Roux, Carole Ford-Chessel, Elodie Gervet, Céline Giraud, Tiphanie Ginhoux, Fleur Cour-Andlauer, Etienne Javouhey, Lyvonne Tume

*Corresponding author for this work

Research output: Contribution to journalArticle (journal)peer-review

18 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)714-721
Number of pages8
JournalPediatric Critical Care Medicine
Volume20
Issue number8
DOIs
Publication statusPublished - 1 Aug 2019

Keywords

  • failure to thrive
  • faltering growth
  • malnutrition
  • pediatric intensive care

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