Management of Enteral Nutrition in the Pediatric Intensive Care Unit: Prokinetic Effects of Amoxicillin/Clavulanate in Real Life Conditions

Fabrizio Chiusolo; Teresa Capriati; Ilaria Erba; Roberto Bianchi; Marta Luisa Ciofi degli Atti; Sergio Picardo; Antonella Diamanti

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자료유형: 학술저널

저자정보: Fabrizio Chiusolo (Bambino Gesu Children's Hospital) Teresa Capriati (Bambino Gesu Children's Hospital) Ilaria Erba (Bambino Gesu Children's Hospital) Roberto Bianchi (Bambino Gesu Children's Hospital) Marta Luisa Ciofi degli Atti (Bambino Gesu Children's Hospital) Sergio Picardo (Bambino Gesu Children's Hospital) Antonella Diamanti (Bambino Gesu Children's Hospital)

저널정보: 대한소아소화기영양학회 Pediatric Gastroenterology, Hepatology & Nutrition Pediatric Gastroenterology, Hepatology & Nutrition 제23권 제6호

발행연도: 2020.1

수록면: 521 - 530 (10page)

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연구주제

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연구배경

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Purpose: Malnutrition is a common feature in critically ill children. Enteral nutrition (EN) is the main strategy to nutritionally support critical ill children, but its use can be hindered by the development of intolerance. The study aimed to assess the effectiveness and safety of amoxicillin/clavulanate (A/C) to treat EN intolerance. Methods: We retrospectively evaluated patients admitted to the pediatric intensive care unit from October 2018 to October 2019. We conducted a case-control study: in the first 6 months (October 2018-April 2019) we implemented the nutritional protocol of our Institution with no drug, whereas in the second half (May 2019-October 2019) we employed A/C for 1 week at a dose of 10 mg/kg twice daily. Results: Twelve cases were compared with 12 controls. At the final evaluation, enteral intake was significantly higher than that at baseline in the cases (from 2.1±3.7 to 66.1±27.4% of requirement, p=0.0001 by Wilcoxon matched-pairs signed rank test) but not in the controls (from 0.2±0.8 to 6.0±14.1% of the requirement, p=NS). Final gastric residual volume at the end of the observation was significantly lower in the cases than in the controls (p=0.0398). The drug was well tolerated as shown by the similar safety outcomes in both cases and controls. Conclusion: Malnutrition exposes critically ill children to several complications that affect the severity of disease course, length of stay, and mortality; all may be prevented by early EN. The development of intolerance to EN could be addressed with the use of A/C. Future prospective clinical trials are needed to confirm these conclusions.

#Gastrointestinal motility #Amoxycillin clavulanic acid #Enteral nutrition #Nutrition disorder #Pediatric intensive care unit #Prokinetic #Amoxicillin

참고문헌 (24)

참고문헌 신청

Mehta NM / 2009 / Nutritional deficiencies during critical illness / Pediatr Clin North Am 56:1143~1160

Kim H / 2012 / Why patients in critical care do not receive adequate enteral nutrition? A review of the literature / J Crit Care 27:702~713

de Menezes FS / 2013 / What are the factors that influence the attainment of satisfactory energy intake in pediatric intensive care unit patients receiving enteral or parenteral nutrition / Nutrition 29:76~80

Braegger C / 2010 / Practical approach to paediatric enteral nutrition : a comment by the ESPGHAN committee on nutrition / J Pediatr Gastroenterol Nutr 51:110~122

Canarie MF / 2015 / Risk factors for delayed enteral nutrition in critically ill children / Pediatr Crit Care Med 16:e283~9

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