Enteral Nutrition Practices during Non-invasive Ventilation in Critically Ill Children: Secondary Analysis of the NIV Dex EN Study
Abstract
Introduction: Despite the widespread use of non-invasive ventilation (NIV) in pediatric intensive care units (PICUs), little has been published regarding enteral nutrition (EN) in this setting. This pre-planned secondary analysis of the Association of Enteral Nutrition and Dexmedetomidine Usage for Critically Ill Children Requiring Non-Invasive Ventilation study aimed to describe current feeding practices during NIV in a large sample, including differences in timing, energy and protein delivery across NIV modes and interfaces. Methods: Secondary analysis of a retrospective study of 1763 patients acutely supported with NIV over one year in fourteen PICUs in the United States. Results: 1065 subjects (60.4%) received EN, with younger children fed vs not fed (median [IQR] 12 months [4,72] vs 24 months [9,96], p<0.001). The overall median (IQR) of energy delivered as a percentage of the goal was 105% (79,121). The overall median (IQR) of the protein delivered was 79% (61,86) of the benchmark. Most were fed via gastric route [50% PO (including 5% breastfed), 20% NG and 16.5% GT] vs. 13.5% post-pyloric. Both NIV interface (p<0.001) and modality (p<0.001) were associated with timing of initiation of EN. NIV failure rate was higher in those not fed n=76 (10.8%) vs n=24(2.2%); p<0.0001. Conclusion: In this large sample exploring current practices of EN provided during NIV support in pediatric ICUs, the majority of children were fed. Documenting this prevalence highlights the need for…
How strong is the evidence?
Evidence Hub reads this as a secondary / pooled analysis, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 1,763 participants or records.
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