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. 2021 Sep 21;13(1):18-24.
doi: 10.1055/s-0041-1736146. eCollection 2024 Mar.

Nutritional Intake in Children with Septic Shock: A Retrospective Single-Center Study

Angela H P Kirk  1 , Chengsi Ong  2 , Judith J-M Wong  3   4 , Sin Wee Loh  3 , Yee Hui Mok  3 , Jan Hau Lee  3   4
Affiliations

Nutritional Intake in Children with Septic Shock: A Retrospective Single-Center Study

Angela H P Kirk et al. J Pediatr Intensive Care. .

Abstract

Nutritional practice in children with severe sepsis or septic shock remains poorly described. We aimed to describe nutrition received by children with severe sepsis or septic shock and explore the association of nutritional intake with clinical outcomes. This study was a retrospective study of children who required pediatric intensive care unit (PICU) admission from 2009 to 2016. Outcomes were mortality, ventilator-free days (VFDs), and PICU-free days (IFDs). A total of 74 patients with septic shock or severe sepsis were identified. Forty-one (55.4%) patients received enteral nutrition (EN) only, 6 (8.1%) patients received parental nutrition (PN) only, 15 (20.3%) patients received both EN and PN, and 12 (16.2%) patients received intravenous fluids alone. Eight of 74 (10.8%) and 4 of 74 (5.4%) had adequate energy and protein intake, respectively. Patients who received early EN had lower odds of 28-day mortality (adjusted hazard ratio [HR] = 0.09, 95% confidence interval [CI]: 0.02, 0.45, p = 0.03) more 28-day VFDs (adjusted β-coefficient = 18.21 [95% CI: 11.11, 25.32], p < 0.001), and IFDs (adjusted ß-coefficient = 16.71 [95% CI: 9.86, 23.56], p < 0.001) than patients who did not receive EN. Late EN was also associated with lower odds of mortality, more VFDs, and IFDs compared with no EN (HR = 0.06, 95% CI: 0.02, 0.23; p < 0.001; adjusted β coefficient = 15.66, 95% CI: 9.31, 22.02; p < 0.001; and 12.34 [95% CI: 6.22, 18.46], p < 0.001; respectively). Inadequate calories and protein were not associated with mortality. EN in children with septic shock or severe sepsis was associated with improved clinical outcomes. Future prospective studies are required to explore the impact of EN timing and optimal nutritional intake in these children.

Keywords: critically ill children; enteral nutrition; pediatric intensive care unit; septic shock.

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Conflict of interest statement

Conflict of Interest None declared.

Figures

Fig. 1
Fig. 1
Energy intake in the first 7 days of PICU stay in children with septic shock ( n  = 74). EN, enteral nutrition; PICU, pediatric intensive care unit.
Fig. 2
Fig. 2
Protein intake in the first 7 days of PICU stay in children with septic shock ( n  = 74). EN, enteral nutrition; PICU, pediatric intensive care unit.
Fig. 3
Fig. 3
Kaplan–Meier survival pattern of children with severe sepsis or septic shock and enteral nutrition. EN, enteral nutrition; PICU, pediatric intensive care unit.
See this image and copyright information in PMC

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