The Use of Transpyloric Enteral Nutrition in the Critically Ill Child
Article first published online: 28 JUN 2008
Journal of Intensive Care Medicine
Volume 15, Issue 5, pages 247–254, September/October 2000
How to Cite
Sánchez, C., López-Herce, J., Moreno de Guerra, M., Carrillo, A., Moral, R. and Sancho, L. (2000), The Use of Transpyloric Enteral Nutrition in the Critically Ill Child. Journal of Intensive Care Medicine, 15: 247–254. doi: 10.1046/j.1525-1489.2000.00247.x
- Issue published online: 28 JUN 2008
- Article first published online: 28 JUN 2008
- Received Sep 30, 1999, and in revised form Mar 9, 2000. Accepted for publication Mar 16, 2000.
To assess the use and complications of transpyloric enteral nutrition (TEN) in the critically ill child we evaluated prospectively all children who received TEN in a pediatric intensive care unit (PICU) of a tertiary university hospital. The type of nutrition used, its duration, medication administered, tolerance, gastrointestinal complications (vomiting, abdominal distension or excessive gastric residue, diarrhea, and pulmonary aspiration), nongastrointestinal complications, and mortality were assessed. A comparative analysis was made between the first 2 years of the study and the remaining period. Over a period of 4.5 years, 152 patients between the ages of 3 days and 17 years received TEN for a duration of 19 ± 32.3 days (range 1–240 days). Forty-one patients received TEN during the first 2 years; 100 patients received TEN in the postoperative period after cardiac surgery (66%). One hundred seventeen patients (77%) received sedation and 65 (43%) received muscle relaxants, presenting no extra complications. Twenty-four patients (15.8%) presented with gastrointestinal complications: abdominal distension and/or excessive gastric residue in 17 and diarrhea in 11. Gastrointestinal intolerance was associated with pulmonary infection (p < 0.05), altered hepatic function (p < 0.001), and hypokalemia or hypocalcemia (p < 0.05). Diarrhea was more frequent in patients with shock (p < 0.05), altered hepatic function (p < 0.05), excessive gastric residue (p < 0.001), and hypokalemia or hypocalcemia (p < 0.05). In the second study period, the number of patients on TEN and the doses of sedatives, muscle relaxants, and vasoactives were higher (p < 0.05), with no increase in the incidence of complications. TEN is a useful method of nutrition with few complications in the critically ill child.