Energy balance and prognosis of children with mechanical ventilation in pediatric intensive care unit
10.3760/cma.j.issn.1674-635X.2019.04.004
- VernacularTitle:PICU机械通气患儿能量平衡及结局探讨
- Author:
Zhuo LI
1
;
Yanhua LIU
;
Jun CHEN
;
Shaodong ZHAO
;
Jirong QI
;
Hongjun MIAO
;
Xiaonan LI
Author Information
1. 南京医科大学附属儿童医院重症医学科
- Keywords:
Nutritional risk;
Resting energy;
Mechanical ventilation;
Energy balance
- From:
Chinese Journal of Clinical Nutrition
2019;27(4):221-226
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the influencing factors for energy balance and the relationship be-tween energy balance and clinical outcome in PICU mechanical ventilation children. Methods Children with mechanical ventilation who were hospitalized in PICU for more than 3 days from June 2015 to May 2016 were collected, resting energy expenditure was measured by resting energy metabolic detector, and the nutrition bal-ance was calculated, the influencing factors on energy balance was analyzed by regression analysis. Results A total of 104 mechanical ventilation children were included with the average energy consumption of ( 265. 4 ± 63. 2) kJ/kg in the first 3 days and the average energy supply of (219. 8±82. 9) kJ/kg, and failed to reach the target value ( P<0. 05) . As the time of hospitalization was prolonged, the supply of energy increased gradu-ally, the SAPS Ⅱ ( r=-0. 609, P=0. 000) , mechanical ventilation time ( r=-0. 456, P=0. 000) , ICU stay time ( r=-0. 646, P=0. 000) , the number of organ failure ( r=-0. 568, P=0. 000) , infection complications ( r=-0. 859, P=0. 000) were negatively correlated to energy supply balance; regression analysis showed that complications of nosocomial infection ( P = 0. 000 ) , number of organ failure ( P = 0. 000 ) , mechanical ventilation time ( P=0. 000) , ICU retention time ( P=0. 001) were predictors of energy supply balance. Con-clusion Insufficient supply of energy for the first three days of mechanical ventilation is high in the critically ill children. Factors affecting energy supply balance include patient's organ failure, infection complications, me-chanical ventilation time, and ICU retention time, which suggest that the strengthening of the nutritional man-agement of the critically ill children with mechanical ventilation will benefit to the clinical outcome.
