TY - JOUR
T1 - Postpyloric vs gastric enteral nutrition in critically ill children
T2 - A single-center retrospective cohort study
AU - Martinez, Enid E.
AU - Melvin, Patrice
AU - Callif, Charles
AU - Turner, Ashley D.
AU - Hamilton, Susan
AU - Mehta, Nilesh M.
N1 - Funding Information:
These studies were supported by NIH grants R01HD085994, NIH R21HD109807, and T32HD098068 (to S.A.P.). Advanced Technology Core services at Baylor College of Medicine are supported from the NIH (NCI grant P30 CA125123). BKP, SMB, and AAA were supported by a predoctoral fellowship from T32HD098068.
Funding Information:
The authors thank Drs. Deborah L. Johnson (Baylor College of Medicine) for the and expression plasmids and Aleksandar Rajkovic (University of California, San Francisco) for the , rabbit anti‐SOHLH1 antibody, and and luciferase reporter plasmids. We also thank Amanda Rodriguez for initial characterization of the line. We additionally thank Ernesto Salas and Hannia Torralba‐Salazar for technical assistance. We also thank the Directors and staff at the following BCM advanced technology cores for assistance with these studies: Genetically Engineered Rat and Mouse Core, Human Tissue Acquisition and Pathology Core, Optical Imaging & Vital Microscopy Core, and Integrated Microscopy Core. Core services at Baylor College of Medicine were supported from the NIH (NCI grant P30 CA125123). Myc‐Sumo1ρ Myc‐Sumo2ρ pFLAG‐Nobox Gdf9 Pou5f1 Nobox K125R
Publisher Copyright:
© 2023 American Society for Parenteral and Enteral Nutrition.
PY - 2023/5
Y1 - 2023/5
N2 - Background: We aimed to describe enteral nutrition (EN) delivery in patients receiving postpyloric EN (PPEN) vs gastric EN (GEN). Methods: Single-center retrospective study including patients aged <21 years admitted to an intensive care unit in a pediatric quaternary care hospital for ≧48 h who received PPEN or GEN as a first approach, as guided by a nutrition algorithm. PPEN patients were 1:1 propensity score matched to GEN patients on demographics, clinical characteristics, and disease severity. Days to EN initiation from admission, percentage of EN adequacy (delivered EN volume/prescribed EN volume) on days 1–3 and 7 after EN initiation, and time to achieving 60% of prescribed EN volume were compared between the two groups using Wilcoxon Mann-Whitney tests and a Cox proportional hazards model. Data are presented as median (IQR1, IQR3). Results: Forty-six PPEN and 46 GEN patients were matched. Median time to EN initiation was 3.25 (2, 6.8) days for PPEN and 4.15 (1.5, 7.1) days for GEN (P = 0.6). Percentage of EN adequacy was greater for PPEN than GEN patients (day 1 PPEN 59.4% [18.8, 87.5] vs GEN 21.1% [7.8, 62.8], day 2 PPEN 54.3% [16.7, 95.8] vs GEN 24% [5.4, 56.7], day 3 PPEN 65.4% [14.7, 100] vs GEN 16% [0, 64.6], day 7 PPEN 77.8% [11.1, 100] vs GEN 13.8% [0, 74.5]; P < 0.05). PPEN patients had greater likelihood of achieving 60% of their prescribed EN volume than GEN patients (hazard ratio 1.84, 95% CI 1.07–3.15; P = 0.028). Conclusion: PPEN was associated with greater EN delivery compared with GEN.
AB - Background: We aimed to describe enteral nutrition (EN) delivery in patients receiving postpyloric EN (PPEN) vs gastric EN (GEN). Methods: Single-center retrospective study including patients aged <21 years admitted to an intensive care unit in a pediatric quaternary care hospital for ≧48 h who received PPEN or GEN as a first approach, as guided by a nutrition algorithm. PPEN patients were 1:1 propensity score matched to GEN patients on demographics, clinical characteristics, and disease severity. Days to EN initiation from admission, percentage of EN adequacy (delivered EN volume/prescribed EN volume) on days 1–3 and 7 after EN initiation, and time to achieving 60% of prescribed EN volume were compared between the two groups using Wilcoxon Mann-Whitney tests and a Cox proportional hazards model. Data are presented as median (IQR1, IQR3). Results: Forty-six PPEN and 46 GEN patients were matched. Median time to EN initiation was 3.25 (2, 6.8) days for PPEN and 4.15 (1.5, 7.1) days for GEN (P = 0.6). Percentage of EN adequacy was greater for PPEN than GEN patients (day 1 PPEN 59.4% [18.8, 87.5] vs GEN 21.1% [7.8, 62.8], day 2 PPEN 54.3% [16.7, 95.8] vs GEN 24% [5.4, 56.7], day 3 PPEN 65.4% [14.7, 100] vs GEN 16% [0, 64.6], day 7 PPEN 77.8% [11.1, 100] vs GEN 13.8% [0, 74.5]; P < 0.05). PPEN patients had greater likelihood of achieving 60% of their prescribed EN volume than GEN patients (hazard ratio 1.84, 95% CI 1.07–3.15; P = 0.028). Conclusion: PPEN was associated with greater EN delivery compared with GEN.
KW - children
KW - critical care
KW - enteral nutrition
KW - gastric
KW - postpyloric
UR - http://www.scopus.com/inward/record.url?scp=85148503902&partnerID=8YFLogxK
U2 - 10.1002/jpen.2482
DO - 10.1002/jpen.2482
M3 - Article
C2 - 36722708
AN - SCOPUS:85148503902
SN - 0148-6071
VL - 47
SP - 494
EP - 500
JO - Journal of Parenteral and Enteral Nutrition
JF - Journal of Parenteral and Enteral Nutrition
IS - 4
ER -