Navigation Links
Registered dietitians help critically ill children get necessary nutrition for recovery

Philadelphia, PA, June 28, 2013 For the first time, researchers investigated enteral nutrition and caloric requirements (CR) among critically ill children in a new report published in the Journal of the Academy of Nutrition and Dietetics. This study also showed the value of including registered dietitians in the medical team.

Providing early nutritional support through the intestine, or enteral route, to critically ill adults has been an effective strategy to improve the healing process. Using a similar approach with critically ill children, however, may present challenges, such as an inability to accurately estimate CR or an inability to administer the CR because of fluid restrictions, procedures, and other barriers. Despite these perceived challenges and a lack of data, many experts believe that early enteral nutrition should be considered in most Pediatric Intensive Care Unit (PICU) patients.

"Our main objective was to examine the practice of early documentation of estimated caloric requirement in the medical record of critically ill children to determine if this would have any effect on their daily caloric intake and the route of nutrition being used to provide them with nutritional support," says lead investigator Martin Wakeham, MD, FAAP, Assistant Professor of Pediatrics, Pediatric Critical Care, Medical College of Wisconsin, Children's Hospital of Wisconsin, Milwaukee. "We hypothesized that there would be a higher total daily caloric intake and more frequent use of enteral nutrition when a CR is estimated and documented in the medical record within 48 hours of PICU admission."

Five PICUs participated in the study. Four of these units were located in independent children's hospitals and one was part of a large community hospital. The study team collected and analyzed data from two sources: Medical records detailing the nutritional intake (nutrition route, quantity, content, presence or absence of an estimated CR) of 1349 patients, who were admitted between January 1, 2007 and December 31, 2008, aged between 30 days and 18 years, and remained in the PICU for 96 hours or more; and a multisite clinical database dedicated to data sharing and benchmarking among PICUs. Investigators also noted the type of provider when an estimated CR was present.

Careful analysis of data revealed that nearly 50 percent of the patients had a documented CR. Other findings include the following:

  • Compared to patients without a CR, these patients were younger, had a higher risk of mortality, and were less likely to be post-operative
  • Patients were more likely to receive enteral nutrition on each of the first four days of admission to the PICU
  • Patients had a higher total daily caloric intake by enteral route and parenteral route combined on each of the first four days of their stay in the PICU
  • More than 90 percent showed an estimated CR equal to or greater than the World Health Organization's calculated resting energy expenditure (REE).
  • A registered dietitian determined the documented CR in more than 95 percent of the cases

"A CR documented in the medical record is evidence that at least a member of the health care delivery team included nutritional support and therapy in the treatment plan for that particular patient. Likewise, not having a CR present in the medical record might be evidence that the subject of nutritional therapy was never addressed in those patients," says Dr. Wakeham. "Another interesting finding is that almost all of the CRs present early in the medical records were entered by a registered dietitian and not by an attending physician or other medical care provider. This finding illustrates the favorable and important impact that registered dietitians can have on the nutritional outcomes of PICU patients."


Contact: Eileen Leahy
Elsevier Health Sciences

Related biology news :

1. University of Illinois professor develops tool that helps dietitians deliver info clients need and can understand
2. Study documents decimation of critically endangered forest elephant
3. DNA reveals mating patterns of critically endangered sea turtle
4. Fish oil helps heal bed sores of the critically ill
5. New data on islet autoantibodies in young children defines early type 1 diabetes development
6. CSHL geneticists solve mystery of EEC Syndromes variable severity in children
7. Surge in children accidentally eating marijuana-laced foods
8. Study links chemicals widely found in plastics and processed food to elevated blood pressure in children and teens
9. New research identifies risks, interventions for childrens GI health
10. Children living near toxic waste sites experience higher blood lead levels resulting in lower IQ
11. Developmental delays in children following prolonged seizures
Post Your Comments:
(Date:9/24/2015)... Publiceringsförbud fram till: ... Kerv ( ), det Londonbaserade ... första kontaktlösa betalningsring på i ett ... för massproduktion via crowdfunding.       ... Kerv-bärare kan göra direkta kontaktlösa betalningar ...
(Date:9/10/2015)... LONDON , Sept. 10, 2015 ... This New Study Reveals Selling Opportunities and Revenue ... What,s the future of biologics, especially new drug ... You will stay ahead with exclusive market data ... can explore trends, developments, results, opportunities and sales ...
(Date:9/10/2015)... 10, 2015 Pursuant Health has collaborated ... create an interactive, image-based health risk assessment (HRA) ... kiosk.  The unique assessment quantifies user results into ... suggests an individual,s biological age based on personal ... by the kiosk. Comprised of age, ...
Breaking Biology News(10 mins):
(Date:10/13/2015)... N.J. and SAN DIEGO ... and Mast Therapeutics, Inc. have agreed to collaborate in ... excipient-grade poloxamer 188 NF, marketed by BASF under the ... in a variety of pharmaceutical and biological applications, such ... 188 is the starting material for Mast,s lead product ...
(Date:10/13/2015)... , Oct. 13, 2015  According to ... services will reach $102 billion by the end ... of the health industry, as it is estimated ... result of laboratory tests. In addition to diagnosing ... to evaluate disease progression, monitor drug treatment and ...
(Date:10/13/2015)... ... October 13, 2015 , ... Clinovo recently appointed Jeff ... the company’s fast growing clinical data solutions business. , Jeff Parr has spent the ... all sizes, including Avery Dennison, Thermo Fisher, and Ab Sciex to name a few. ...
(Date:10/13/2015)... ... October 13, 2015 , ... The New ... age children in the areas of Science, Technology, Engineering and Mathematics. The skill ... economy, and the program aims to increase the number of students who pursue ...
Breaking Biology Technology: