Evaluation of parenteral nutrition practices in pediatric intensive care units

Abstract

Purpose

This study aimed to assess parenteral nutrition (PN) practices in pediatric intensive care units (PICUs) in Turkey and compare them with existing literature.

Material and methods

A prospective survey was conducted among physicians from 37 PICUs. The survey, based on literature and guidelines, collected data that were statistically analyzed.

Results

Malnutrition was a significant factor in initiating PN in 91.9% of units, with the weight-for-height scale being the most common method (59.5%) for assessing malnutrition. PN was started within the first week in 73.9% of non-malnourished children who could not be fed enterally, while for chronically malnourished children, 27% initiated PN within 48 hours of admission. The most frequently used methods for determining PN amounts were the Holiday-Segar formula and body surface area calculations (56.8% and 45.9%, respectively). Energy requirements were mainly calculated based on weight (59.5%) or the Schofield formula (40.5%). Within the first week, 54.1% of units reached 2/3 of target calories in 75% of their patients. Ready-to-use solutions were preferred by 81.1% of units. The most common PN-related complications were electrolyte imbalances (31.3%) and infections (22.8%).

Conclusions

The study highlights the need for applicable guidelines and standardized nutrition education, emphasizing that factors like malnutrition frequency, methods for determining caloric needs, the availability of PN products, and unit capabilities are crucial considerations for developing country-specific guidelines.