Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI 49503, USA.
Pediatric Critical Care Medicine, Helen DeVos Children's Hospital, Grand Rapids, MI 49503, USA.
Nutrients. 2023 Jul 20;15(14):3221. doi: 10.3390/nu15143221.
Nutrition in pediatric populations who require life-saving extracorporeal membrane oxygenation (ECMO) remains a debate. We sought to identify if nutritional needs were met in a patient cohort. A retrospective chart review of patients (N = 64) requiring ECMO at Helen DeVos Children's Hospital between 2018 and 2022 was evaluated for demographics, daily nutritional data, laboratory values, ECMO complications, and outcome data, with primary outcome measures of percent protein and percent caloric intake. Secondary outcome measures included the intensive care unit length of stay, time on ECMO, mortality, and day 1 severity of illness scores (Pediatric Logistic Organ Dysfunction). The timeline partially overlapped with the COVID-19 pandemic. Data were collected for 467 ECMO days with a median age of 2.6 months; 57.8% of patients were male and 65.6% were with one pre-existing comorbidity. Venoarterial (VA) ECMO was utilized in 84.4% of patients; the ECMO indication was cardiac in 53.1% of patients. The 28-day mortality was 43.8%. The proportion of days in which the caloric goal was met was 0%; the proportion of days in which protein goals were met was 33.3%. Non-cardiac ECMO patients had a greater number of days where caloric goals were met (-value = 0.04). Mortality at 28 days was not statistically significant (-value = 0.28) for calories or protein administered. The patient cohort struggled to meet calorie and protein goals while on ECMO.
需要救命性体外膜肺氧合（ECMO）的儿科患者的营养问题仍存在争议。我们旨在确定患者群体的营养需求是否得到满足。回顾性分析了 2018 年至 2022 年在海伦·德沃斯儿童医院接受 ECMO 的 64 例患者的病历，评估了人口统计学资料、每日营养数据、实验室值、ECMO 并发症和结局数据，主要结局指标为蛋白质和热量摄入百分比。次要结局指标包括重症监护病房住院时间、ECMO 时间、死亡率和第 1 天疾病严重程度评分（小儿逻辑器官功能障碍）。该时间线与 COVID-19 大流行部分重叠。共收集了 467 个 ECMO 日的数据，中位年龄为 2.6 个月；57.8%的患者为男性，65.6%的患者存在 1 种预先存在的合并症。84.4%的患者接受了静脉动脉（VA）ECMO；53.1%的患者 ECMO 指征为心脏。28 天死亡率为 43.8%。满足热量目标的天数比例为 0%；满足蛋白质目标的天数比例为 33.3%。非心脏 ECMO 患者满足热量目标的天数更多（-值=0.04）。在卡路里或蛋白质给药方面，28 天死亡率无统计学意义（-值=0.28）。患者在接受 ECMO 治疗时，难以达到热量和蛋白质目标。
