Nutrients · 2024
Nutritional Intake in Venovenous ECMO Patients: A Single-Center Study in a North American PICU.
СтатьяНазвание и аннотация: Перевод в очереди
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Lintvedt Annika, Purosky Isabella, Kogelschatz Benjamin, Brackmann Megan, Heinze Erika, Parker Jessica, Dudick Brooke, Mcdiarmid Jamie, Rosner Elizabeth, Boville Brian, Leimanis-Laurens Mara L
Аннотация
BACKGROUND/OBJECTIVES: Multiple independent variables were analyzed to determine total nutritional intake (caloric and protein), while reviewing vasoactive inotrope scores (VISs).
METHODS: Retrospective data were collected for nutritional intake (N = 64), daily VISs, extracorporeal membrane oxygenation (ECMO) complications, delays in nutritional intake (>48 h), reason for delay, and interruptions in nutrition support.
RESULTS: VISs and ECMO characteristics analyzed by box-whisker plots demonstrated that ECMO complications prior to 24 h, cardiac arrest 24 h prior to ECMO, pediatric ECMO patients, venoarterial ECMO type, having a cardiac ECMO indication, and ECMO centrifugal pump had higher VISs. A regression analysis revealed that venovenous ECMO patients and the centrifugal pump type had higher caloric and protein intake; subsequently, for each increase in VIS, caloric intake decreased by -0.54. Sixteen patients did not receive nutritional support while on ECMO (9/16; 56% cardiac); 12/48 (25%) had a delay, with the cardiac patients nearing statistical significance.
CONCLUSION: Venovenous ECMO (non-cardiac) correlated with higher nutritional intake. The enteral administration of nutrition had a lower VIS on average compared to the other three groupings, namely enteral vs. parenteral; enteral vs. both enteral and parenteral; enteral vs. no nutrition. This study provides additional clinical insight on nutritional intake in ECMO patients.
METHODS: Retrospective data were collected for nutritional intake (N = 64), daily VISs, extracorporeal membrane oxygenation (ECMO) complications, delays in nutritional intake (>48 h), reason for delay, and interruptions in nutrition support.
RESULTS: VISs and ECMO characteristics analyzed by box-whisker plots demonstrated that ECMO complications prior to 24 h, cardiac arrest 24 h prior to ECMO, pediatric ECMO patients, venoarterial ECMO type, having a cardiac ECMO indication, and ECMO centrifugal pump had higher VISs. A regression analysis revealed that venovenous ECMO patients and the centrifugal pump type had higher caloric and protein intake; subsequently, for each increase in VIS, caloric intake decreased by -0.54. Sixteen patients did not receive nutritional support while on ECMO (9/16; 56% cardiac); 12/48 (25%) had a delay, with the cardiac patients nearing statistical significance.
CONCLUSION: Venovenous ECMO (non-cardiac) correlated with higher nutritional intake. The enteral administration of nutrition had a lower VIS on average compared to the other three groupings, namely enteral vs. parenteral; enteral vs. both enteral and parenteral; enteral vs. no nutrition. This study provides additional clinical insight on nutritional intake in ECMO patients.