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The Indian Journal of Pediatrics最新文献

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Comparison of Protocol-Based Continuous and Intermittent Tube Feeding in Mechanically Ventilated Critically Ill Children – An Open Label Randomized Controlled Trial 机械通气危重症儿童基于协议的持续性和间歇性管饲比较--开放标签随机对照试验
Pub Date : 2023-12-08 DOI: 10.1007/s12098-023-04941-x
Vijaya Kumar, Jhuma Sankar, Manisha Jana, Kana Ram Jat, S. K. Kabra, Rakesh Lodha

Objectives

To compare the time taken to reach the target calories and proteins by protocol based “continuous tube feeding (CTF)” and “intermittent tube feeding (ITF)” in critically ill children.

Methods

This trial was conducted in the Pediatric Intensive Care Unit (PICU) of a tertiary care institute. Eligible children were randomized to receive CTF or ITF. Target calories were defined as 70% of calorie amount as per the WHO formula and target protein was defined as 1.5 g/kg as per the American Society of Parenteral and Enteral Nutrition (ASPEN) criteria. The primary outcome was time taken to reach target calories, the secondary outcomes were time taken to reach target protein, incidence of feed intolerance, PICU mortality, duration of ventilation, and outcome on 28th day.

Results

Fifty-eight children were randomized; 29 in each group. The baseline characters were comparable. The median (IQR) times for reaching target calories were 1.7 (1.4, 2.5) d and 1.8 (1.4, 4.4) d in the CTF and ITF groups, respectively [Hazards ratio (HR) 0.89 (95% CI 0.5, 1.5); p = 0.69]. For the target protein intake, the median times were comparable in the 2 groups [HR 0.82 (95% CI 0.4-1.5); = 0.55]. The other outcomes were not significantly different between the groups.

Conclusions

The authors did not observe any difference in the time taken to reach target calories and protein between the two different modes of delivery of enteral nutrition.

目的比较重症患儿通过基于方案的 "连续管饲 (CTF) "和 "间歇管饲 (ITF) "达到目标卡路里和蛋白质所需的时间。 方法这项试验在一家三级医疗机构的儿科重症监护室 (PICU) 中进行。符合条件的患儿被随机分配接受 CTF 或 ITF。根据世界卫生组织的公式,目标卡路里定义为卡路里量的 70%,根据美国肠外和肠内营养学会(ASPEN)的标准,目标蛋白质定义为 1.5 克/千克。主要结果是达到目标卡路里所需的时间,次要结果是达到目标蛋白质所需的时间、饲料不耐受发生率、PICU 死亡率、通气时间和第 28 天的结果。基线特征具有可比性。CTF 组和 ITF 组达到目标热量的中位时间(IQR)分别为 1.7 (1.4, 2.5) d 和 1.8 (1.4, 4.4) d [危险比 (HR) 0.89 (95% CI 0.5, 1.5); p = 0.69]。就目标蛋白质摄入量而言,两组的中位时间相当[HR 0.82 (95% CI 0.4-1.5); p = 0.55]。结论作者没有观察到两种不同的肠内营养供给模式在达到目标卡路里和蛋白质摄入量所需的时间上有任何差异。
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期刊
The Indian Journal of Pediatrics
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