Nutrition support and Energy balance following

pediatric intensive care unit admission

Eun Mi Lee , Mi ° Young Moon, Jae Youn Kim, Hye Young Shin

Department of Pharmacy, Asan Medical Center

Background : Nutritional support is a basic component of clinical management in the PICU. Adequate nutirition is associated with physiologic stability and outcome. Hence, assessment of energy requirements is essential for nutritional management.

Objective : The study assessed the adequacy of nutrition support and compared actually administered energy , resting energy expenditure (REE) predicted by Schofield’sequation in critically ill children during the first 7 days following admission.

Methods : 18 children (median age 6.99 mo; range, 8d-14y) who were admitted to to Asan Medical Center PICU between 2006.8 and 2006.10. Patients who received parenteral or combination of enteral and parenteral nutrition over 7 days were eligible for inclusion. Patients were assigned to one of two groups : patients after cardiac surgery(n=6), and all other diagnoses (n=12).

Results : Administered energy rose significantly during the course of stud (R2=0.868, p=0.002). The average of administered energy did not differ between cardiac surgery group and non-cardiac group. Patients in the PICU received a median 59.8%(range 5.4-200%) of their REEs predicted by Schofield equation.

Conclusion : Restriction of fluid intake was the main barrier to delivery of adequate nutrition. A problem specific to pediatric patients relates to fluid restriction so after deducting the volume of fluid for prescribed drugs and infusions, the amount available for nutrition was limited. Energy intake was lower than predicted REE in critically ill children in the PICU.