Evaluation of nutritional status in pediatric intensive care unit patients: the results of a multicenter, prospective study in Turkey
Authors: Misirlioglu Merve , Yildizdas Dincer , Ekinci Faruk , Ozgur Horoz Ozden , Tumgor Gokhan , Yontem Ahmet , Talay Mehmet Nur , Kangin Murat , Tufan Erennur , Kesici Selman , Yener Nazik , Kinik Kaya Hatice Elif , Havan Merve , Tunc Ali , Akçay Nihal , Sevketoglu Esra , Durak Fatih , Ozel Dogruoz Aysenur , Ozcan Serhan , Perk Oktay , Duyu Muhterem , Boyraz Merve , Uysal Yazici Mutlu , Ozturk Zeynelabidin , Çeleğen Mehmet , Bukulmez Aysegul , Kacmaz Ebru , Cagri Dinleyici Ener , Dursun Oguz , Koker Alper , Bayraktar Suleyman , Talip Petmezci Mey , Nabaliyeva Aygul , Agin Hasan , Hepduman Pinar , Akkuzu Emine , Kendirli Tanil , Ozen Hasan , Topal Sevgi , Ödek Çağlar , Ozkale Murat , Ozkale Yasemin , Atay Gürkan , Erdoğan Seher , Konca Capan , Yapici Guler , Arslan Gazi , Besci Tolga , Yilmaz Resul , Gumus Meltem , Oto Arzu , Dalkiran Tahir , Mercan Mehmet , Çoban Yasemin , Ipek Sevcan , Gungor Sukru , Arslankoylu Ali Ertug , Alakaya Mehmet , Sari Ferhat , Yucel Aylin , Yazar Abdullah 
Published: August 2023

Introduction

Malnutrition 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 Method

In 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.

Results

Of 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).

Conclusion

Timely 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.