TY - JOUR
T1 - Enteral nutrition in neonatal and pediatric extracorporeal life support
T2 - A survey of current practice
AU - Desmarais, Thomas J.
AU - Yan, Yan
AU - Keller, Martin S.
AU - Vogel, Adam M.
N1 - Funding Information:
Thomas J. Desmarais was supported by a Doris Duke Charitable Research Foundation Grant to Washington University in Saint Louis .
Publisher Copyright:
© 2015 Elsevier Inc. All rights reserved.
PY - 2015
Y1 - 2015
N2 - Purpose: The purpose of this study was to characterize enteral (EN) nutrition practices in neonatal and pediatric patients receiving extracorporeal life support (ECLS). Methods: A Web-based survey was administered to program directors and coordinators of Extracorporeal Life Support Organization centers providing neonatal and pediatric ECLS. The survey assessed patient and clinical factors relating to the administration of EN. Results: A total of 122 responses (122/521, 23.4%) from 96 institutions (96/187; 51.3%) were received. One hundred fifteen provided neonatal or pediatric ECLS, and 84.2% reported utilizing EN during ECLS. 55% and 71% of respondents provide EN 'often' or 'always' for venoarterial and venovenous ECLS, respectively. EN was reported as given 'often' or 'always' by 24% with increased vasopressor support, 53% with "stable" vasopressor support, and 60%withweaning of vasopressor support. Favorable diagnosis for providing EN includes respiratory distress syndrome, pneumonia, asthma, trauma/post-operative, pulmonary hemorrhage, and infectious cardiomyopathy. Vasopressor requirement and underlying diagnosis were the primary or secondary determinant of whether to provide EN 81% and 72% of the time. 38% reported an established protocol for providing EN. Conclusion: EN support is common but not uniform among neonatal and pediatric patients receiving ECLS. ECLS mode, vasopressor status, and underlying diagnosis play an important role in the decision to provide EN.
AB - Purpose: The purpose of this study was to characterize enteral (EN) nutrition practices in neonatal and pediatric patients receiving extracorporeal life support (ECLS). Methods: A Web-based survey was administered to program directors and coordinators of Extracorporeal Life Support Organization centers providing neonatal and pediatric ECLS. The survey assessed patient and clinical factors relating to the administration of EN. Results: A total of 122 responses (122/521, 23.4%) from 96 institutions (96/187; 51.3%) were received. One hundred fifteen provided neonatal or pediatric ECLS, and 84.2% reported utilizing EN during ECLS. 55% and 71% of respondents provide EN 'often' or 'always' for venoarterial and venovenous ECLS, respectively. EN was reported as given 'often' or 'always' by 24% with increased vasopressor support, 53% with "stable" vasopressor support, and 60%withweaning of vasopressor support. Favorable diagnosis for providing EN includes respiratory distress syndrome, pneumonia, asthma, trauma/post-operative, pulmonary hemorrhage, and infectious cardiomyopathy. Vasopressor requirement and underlying diagnosis were the primary or secondary determinant of whether to provide EN 81% and 72% of the time. 38% reported an established protocol for providing EN. Conclusion: EN support is common but not uniform among neonatal and pediatric patients receiving ECLS. ECLS mode, vasopressor status, and underlying diagnosis play an important role in the decision to provide EN.
KW - Critical care
KW - ECLS
KW - ECMO
KW - Enteral
KW - Extracorporeal life support
KW - Nutrition
UR - http://www.scopus.com/inward/record.url?scp=84922540382&partnerID=8YFLogxK
U2 - 10.1016/j.jpedsurg.2014.10.030
DO - 10.1016/j.jpedsurg.2014.10.030
M3 - Article
C2 - 25598094
AN - SCOPUS:84922540382
SN - 0022-3468
VL - 50
SP - 60
EP - 63
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
IS - 1
ER -