Home  |  Top News  |  Most Popular  |  Video  |  Multimedia  |  News Feeds  |  Feedback
  Medicine  |  Nature & Earth  |  Biology  |  Technology & Engineering  |  Space & Planetary  |  Psychology  |  Physics & Chemistry  |  Economics  |  Archaeology
Top > Medicine, Health Care > Registered Dietitians Help Critically Ill… >
Registered Dietitians Help Critically Ill Children Get Necessary Nutrition for Recovery

Published: June 28, 2013.
By Elsevier Health Sciences
http://www.elsevierhealth.com

Philadelphia, PA, June 28, 2013 – For the first time, researchers investigated enteral nutrition and caloric requirements (CR) among critically ill children in a new report published in the Journal of the Academy of Nutrition and Dietetics. This study also showed the value of including registered dietitians in the medical team.

Providing early nutritional support through the intestine, or enteral route, to critically ill adults has been an effective strategy to improve the healing process. Using a similar approach with critically ill children, however, may present challenges, such as an inability to accurately estimate CR or an inability to administer the CR because of fluid restrictions, procedures, and other barriers. Despite these perceived challenges and a lack of data, many experts believe that early enteral nutrition should be considered in most Pediatric Intensive Care Unit (PICU) patients.

"Our main objective was to examine the practice of early documentation of estimated caloric requirement in the medical record of critically ill children to determine if this would have any effect on their daily caloric intake and the route of nutrition being used to provide them with nutritional support," says lead investigator Martin Wakeham, MD, FAAP, Assistant Professor of Pediatrics, Pediatric Critical Care, Medical College of Wisconsin, Children's Hospital of Wisconsin, Milwaukee. "We hypothesized that there would be a higher total daily caloric intake and more frequent use of enteral nutrition when a CR is estimated and documented in the medical record within 48 hours of PICU admission."

Five PICUs participated in the study. Four of these units were located in independent children's hospitals and one was part of a large community hospital. The study team collected and analyzed data from two sources: Medical records detailing the nutritional intake (nutrition route, quantity, content, presence or absence of an estimated CR) of 1349 patients, who were admitted between January 1, 2007 and December 31, 2008, aged between 30 days and 18 years, and remained in the PICU for 96 hours or more; and a multisite clinical database dedicated to data sharing and benchmarking among PICUs. Investigators also noted the type of provider when an estimated CR was present.

Careful analysis of data revealed that nearly 50 percent of the patients had a documented CR. Other findings include the following:

  • Compared to patients without a CR, these patients were younger, had a higher risk of mortality, and were less likely to be post-operative
  • Patients were more likely to receive enteral nutrition on each of the first four days of admission to the PICU
  • Patients had a higher total daily caloric intake by enteral route and parenteral route combined on each of the first four days of their stay in the PICU
  • More than 90 percent showed an estimated CR equal to or greater than the World Health Organization's calculated resting energy expenditure (REE).
  • A registered dietitian determined the documented CR in more than 95 percent of the cases

"A CR documented in the medical record is evidence that at least a member of the health care delivery team included nutritional support and therapy in the treatment plan for that particular patient. Likewise, not having a CR present in the medical record might be evidence that the subject of nutritional therapy was never addressed in those patients," says Dr. Wakeham. "Another interesting finding is that almost all of the CRs present early in the medical records were entered by a registered dietitian and not by an attending physician or other medical care provider. This finding illustrates the favorable and important impact that registered dietitians can have on the nutritional outcomes of PICU patients."




Translate this page: Chinese French German Italian Japanese Korean Portuguese Russian Spanish


Disclaimer: The views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the ScienceNewsline.
Related »

Medical 
2/4/14 
★★ 
Medical Tourists Seeking Treatment Overseas Without Sufficient Information And Advice
By University of York
A team of researchers has found that British people travelling abroad for medical treatment are often unaware of the potential health and financial consequences they could face. The …
Practices 
7/22/13 
Researchers Identify 146 Contemporary Medical Practices Offering No Net Benefits
By Elsevier Health Sciences
Rochester, MN -- While there is an expectation that newer medical practices improve the standard of care, the history of medicine reveals many instances in which this has not …
Patient 
5/9/13 
Patients Should Have Right to Control Genomic Health Information
By Cell Press
Doctors should not have the right or responsibility to force-feed their patients with genomic information about their future health risks, according to bioethicists writing on May 9 in Trends …
Patients 
1/12/13 
Experts Aim to Redefine Healthcare And Research Ethics
By Johns Hopkins Medicine
In what they acknowledge as a seismic shift in the ethical foundation of medical research, practice and policy, a prominent group of interdisciplinary healthcare experts, led by bioethicists at …
Safety 
3/5/13 
Top Patient Safety Strategies Detailed in New AHRQ Report
By University of California - San Francisco
The Agency for Healthcare Research and Quality (AHRQ) has released a new report, Making Health Care Safer II, which identifies the top 10, evidence-based patient safety strategies available to …
Patients 
3/30/11 
Automated Colonoscopy Reminder System Is Effective, Especially in Minority Populations
By American Gastroenterological Association
The simple practice of letters and a telephone call to patients who are due for a colonoscopy significantly improves adherence to endoscopic follow-up recommendations, according to a new study …
Treatment 
9/20/10 
Millions with Voice Problems Don't Know Treatment Available
By Duke University Medical Center
DURHAM, N.C.—Two-thirds of Americans with voice problems don't seek medical care either because they don't know treatment is available or because they think the problem will just go away, …
More » 

Most Popular - Medicine »
MARIJUANA »
Casual Marijuana Use Linked to Brain Abnormalities in Students
CHICAGO --- Young adults who used marijuana only recreationally showed significant abnormalities in two key brain regions that are important in emotion and motivation, scientists report. The study was …
TUMORS »
The Immune System's Redesigned Role in Fighting Cancerous Tumors
LOS ANGELES (March 11, 2014) – Researchers in the Cedars-Sinai Samuel Oschin Comprehensive Cancer Institute eradicated solid tumors in laboratory mice using a novel combination of two targeted agents. …
EATING »
The Surprising Consequences of Banning Chocolate Milk
NEURONS »
Researchers Find Boosting Depression-causing Mechanisms in the Brain Increases Resilience
New York, NY – A new study points to a conceptually novel therapeutic strategy for treating depression. Instead of dampening neuron firing found with stress-induced depression, researchers demonstrated for …
SURFACE »
New Gel to Promote Bone Growth on Implants Used in Surgical Procedures
ScienceNewsline  |  About  |  Privacy Policy  |  Feedback  |  Mobile  |  Japanese
The selection and placement of stories are determined automatically by a computer program. All contents are copyright of their owners except U.S. Government works. U.S. Government works are assumed to be in the public domain unless otherwise noted. Everything else copyright ScienceNewsline.