Sick children who require intensive care unit treatment often have difficulty eating normally, which lands them in a vicious cycle in which they become more susceptible to infection and prolonged illness because of nutrient deficiency.
Current guidelines recommend providing some kind of supplemental nutrition shortly after a child is admitted to an ICU, generally through a nasogastic feeding tube. But this method doesn't always result in optimum recovery for pediatric patients, according to new findings published in the New England Journal of Medicine.
Researchers performed a prospective randomized controlled trial to look at outcomes for 1,440 patients and investigate what differences there might be between those receiving varying types of intravenous feeding at certain points throughout their treatments. They looked at outcomes for patients undergoing enteral nutrition, any kind of feeding that delivers calories through the gastrointestinal tract, and parenteral nutrition, or intravenous feeding.
The investigators found that overall, small amounts of food ingested by mouth, or no food at all either orally or via feeding tube, was associated with better outcomes than artificial nutrition. Children in these groups were less likely to experience complications such as organ failure or infection and recovered faster.
"In critically ill children, withholding parenteral nutrition for one week while administering micronutrients intravenously was clinically superior to providing early parenteral nutrition to supplement insufficient enteral nutrition," the authors wrote.