Association between enteral feeding and gastrointestinal complications in children receiving extracorporeal life support...

Published Date: 31st May 2023

Publication Authors: Tse C

Background
Extracorporeal life support is an accepted treatment modality for children with severe cardiac and/or respiratory dysfunction. However, after a period of inadequate gut perfusion, clinicians are often reluctant to initiate enteral nutrition.

Methods
This was a retrospective cohort study in a single large pediatric intensive care unit in North West England over 5.5 years (2017–2022).

Results
One hundred fifty-six children, who had a median age of 2 months (IQR, 0.3–15) and a mean weight-for-age z score of –1.50 (SD, 1.7), were included. Indications for extracorporeal life support were respiratory failure (31%), cardiac arrest (28%), low cardiac output state (27%), and inability to separate from cardiopulmonary bypass (12%). Most (75%) children were fed during extracorporeal life support, with a median time to initiate feeding of 24 h (IQR, 12.2–42.7). More gastrointestinal complications were associated with being enterally fed (86% vs 14%; P < 0.001), but complications were predominantly feed intolerance (46%), which was associated with receiving formula feeds rather than maternal (breast) milk (P < 0.001). Overall, the proportion of children's median energy targets achieved by 72 h was 38% (IQR, 10.7%−76%), but this varied by support indication.

Conclusion
Our findings suggest most children tolerated enteral feeding within 24 h after extracorporeal life support initiation, with only mild gastrointestinal complications.


Tume, LN; Beech, G; Chi, T et al. (2023). Association between enteral feeding and gastrointestinal complications in children receiving extracorporeal life support: A retrospective cohort study. Journal of parenteral and enteral nutrition. epub 31 May(.), [Online]. Available at: https://doi.org/10.1002/jpen.2528 [Accessed 11 July 2023]

 

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