Frontiers in Pediatrics (Aug 2023)

Evaluation of nutritional status in pediatric intensive care unit patients: the results of a multicenter, prospective study in Turkey

  • Merve Misirlioglu,
  • Dincer Yildizdas,
  • Faruk Ekinci,
  • Ozden Ozgur Horoz,
  • Gokhan Tumgor,
  • Ahmet Yontem,
  • Mehmet Nur Talay,
  • Murat Kangin,
  • Erennur Tufan,
  • Selman Kesici,
  • Nazik Yener,
  • Hatice Elif Kinik Kaya,
  • Merve Havan,
  • Ali Tunc,
  • Nihal Akçay,
  • Esra Sevketoglu,
  • Fatih Durak,
  • Aysenur Ozel Dogruoz,
  • Serhan Ozcan,
  • Oktay Perk,
  • Muhterem Duyu,
  • Merve Boyraz,
  • Mutlu Uysal Yazici,
  • Zeynelabidin Ozturk,
  • Mehmet Çeleğen,
  • Aysegul Bukulmez,
  • Ebru Kacmaz,
  • Ener Cagri Dinleyici,
  • Oguz Dursun,
  • Alper Koker,
  • Suleyman Bayraktar,
  • Mey Talip Petmezci,
  • Aygul Nabaliyeva,
  • Hasan Agin,
  • Pinar Hepduman,
  • Emine Akkuzu,
  • Tanil Kendirli,
  • Hasan Ozen,
  • Sevgi Topal,
  • Çağlar Ödek,
  • Murat Ozkale,
  • Yasemin Ozkale,
  • Gürkan Atay,
  • Seher Erdoğan,
  • Capan Konca,
  • Guler Yapici,
  • Gazi Arslan,
  • Tolga Besci,
  • Resul Yilmaz,
  • Meltem Gumus,
  • Arzu Oto,
  • Tahir Dalkiran,
  • Mehmet Mercan,
  • Yasemin Çoban,
  • Sevcan Ipek,
  • Sukru Gungor,
  • Ali Ertug Arslankoylu,
  • Mehmet Alakaya,
  • Ferhat Sari,
  • Aylin Yucel,
  • Abdullah Yazar

DOI
https://doi.org/10.3389/fped.2023.1179721
Journal volume & issue
Vol. 11

Abstract

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IntroductionMalnutrition is defined as a pathological condition arising from deficient or imbalanced intake of nutritional elements. Factors such as increasing metabolic demands during the disease course in the hospitalized patients and inadequate calorie intake increase the risk of malnutrition. The aim of the present study is to evaluate nutritional status of patients admitted to pediatric intensive care units (PICU) in Turkey, examine the effect of nutrition on the treatment process and draw attention to the need for regulating nutritional support of patients while continuing existing therapies.Material and MethodIn this prospective multicenter study, the data was collected over a period of one month from PICUs participating in the PICU Nutrition Study Group in Turkey. Anthropometric data of the patients, calorie intake, 90-day mortality, need for mechanical ventilation, length of hospital stay and length of stay in intensive care unit were recorded and the relationship between these parameters was examined.ResultsOf the 614 patients included in the study, malnutrition was detected in 45.4% of the patients. Enteral feeding was initiated in 40.6% (n = 249) of the patients at day one upon admission to the intensive care unit. In the first 48 h, 86.82% (n = 533) of the patients achieved the target calorie intake, and 81.65% (n = 307) of the 376 patients remaining in the intensive care unit achieved the target calorie intake at the end of one week. The risk of mortality decreased with increasing upper mid-arm circumference and triceps skin fold thickness Z-score (OR = 0.871/0.894; p = 0.027/0.024). The risk of mortality was 2.723 times higher in patients who did not achieve the target calorie intake at first 48 h (p = 0.006) and the risk was 3.829 times higher in patients who did not achieve the target calorie intake at the end of one week (p = 0.001). The risk of mortality decreased with increasing triceps skin fold thickness Z-score (OR = 0.894; p = 0.024).ConclusionTimely and appropriate nutritional support in critically ill patients favorably affects the clinical course. The results of the present study suggest that mortality rate is higher in patients who fail to achieve the target calorie intake at first 48 h and day seven of admission to the intensive care unit. The risk of mortality decreases with increasing triceps skin fold thickness Z-score.

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