Peptide-based versus standard polymeric enteral nutrition in the PICU: a multicenter observational study.
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Misirlioglu Celik Merve, Yildizdas Dincer, Ekinci Faruk, Yucel Karakaya Sevinc Puren, Duyu Muhterem, Asik Ayse, Akkus Abdullah, Akin Fatih, Ari Hatice Feray, Kiral Eylem, Dinleyici Ener Cagri, Kinik Kaya Hatice Elif, Yener Nazik, Alakaya Mehmet, Arslankoylu Ali Ertug, Segmen Busra, Ozgur Horoz Ozden, Telefon Hasan Ali, Kendirli Tanil, Eyduran Eda, Zengin Neslihan, Akcay Nihal, Bingol Ilyas, Yavuz Sinan, Avci Ali, Ulgen Tekerek Nazan, Erdal Murat, Incekoy Girgin Feyza, Yalindag Makbule Nilufer, Udurgucu Muhammed, Odek Caglar, Arslan Didar, Atay Gurkan, Tugrul Hazal Ceren, Albayrak Hatice
Аннотация
METHODS: This multicenter, prospective study included pediatric patients admitted to PICUs who received enteral nutrition. Patients receiving PBFs were compared with those receiving SPFs. To reduce baseline imbalances and potential confounding, propensity score matching with inverse probability of treatment weighting (IPTW) was applied.
RESULTS: A total of 574 patients were included. After IPTW adjustment, baseline characteristics were well balanced between groups. The rate of achieving target caloric intake by day 2 was significantly higher in the SPF group (p < 0.001); whereas no significant difference was observed by day 7 (mean difference = 0.7, p = 0.853). After adjustment, the incidence of nosocomial infections was significantly higher in the SPF group compared with the PBF group [23.5 vs. 17.6%; OR = 0.7 (95% CI, 0.5-0.9); p = 0.015]. Significantly greater reduction in proteins consumed on day 2 was observed in favor of the SPF group (mean difference -0.3, p < 0.001). Constipation was significantly more common in the SPF group (p = 0.010).
CONCLUSIONS: Although early caloric and protein intake was higher in patients receiving standard polymeric formulas, outcomes were comparable by day 7. Lower infection rates and reduced need for mechanical ventilation were observed in patients receiving peptide-based formulas. Enteral formula selection should be individualized, and further studies are needed to clarify this subject.