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Abstract：
Patients admitted to a pediatric intensive care unit (PICU) need individualized nutrition support that is tailored to their particular disease severity, nutritional status, and therapeutic interventions. We aim to evaluate how calories and proteins are provided during the first seven days of hospitalization for children in critical condition with organ dysfunction (OD). A single-center retrospective cohort study of children aged 2-18 years, mechanically ventilated > 48 h, and admitted > 7 days to a PICU from 2016 to 2017 was carried out. Nutrition support included enteral and parenteral nutrition. We calculated scores for the Pediatric Sequential Organ Failure Assessment (pSOFA) on days 1 and 3 of admission, with OD defined as a score > 5. Of 4199 patient admissions, 164 children were included. The prevalence of OD for days 1 and 3 was 79.3% and 78.7%, respectively. On day 3, when pSOFA scores trended upward, decreased, or remained unchanged, median (IQR) caloric intake was 0 (0-15), 9.2 (0-25), and 22 (1-43) kcal/kg/day, respectively (p = 0.0032); when pSOFA scores trended upward, decreased, or remained unchanged, protein intake was 0 (0-0.64), 0.44 (0-1.25), and 0.66 (0.04-1.67) g/kg/day, respectively (p = 0.0023). Organ dysfunction was prevalent through the first 72 h of a PICU stay. When the pSOFA scores trended downward or remained unchanged, caloric and protein intakes were higher than those that trended upward.
摘要：
入住儿科重症监护病房（PICU）的患者需要根据其特定疾病严重程度量身定制的个性化营养支持。营养状况,和治疗干预措施。我们的目标是评估在患有器官功能障碍（OD）的危重病儿童住院的前7天如何提供卡路里和蛋白质。一项针对2-18岁儿童的单中心回顾性队列研究，机械通气>48小时，并在2016年至2017年期间进入PICU>7天。营养支持包括肠内营养和肠外营养。我们计算了入院第1天和第3天的儿科序贯器官衰竭评估（pSOFA）的分数，OD定义为得分>5。4199名患者入院，共有164名儿童。第1天和第3天的OD患病率分别为79.3%和78.7%,分别。在第3天，当pSOFA分数呈上升趋势时，减少,或者保持不变，卡路里摄入中位数（IQR）为0（0-15），9.2（0-25），和22（1-43）千卡/千克/天，分别(p=0.0032)；当pSOFA分数呈上升趋势时，减少,或者保持不变，蛋白质摄入量为0（0-0.64），0.44（0-1.25），和0.66（0.04-1.67）g/kg/天，分别(p=0.0023)。在PICU住院的前72小时内，器官功能障碍很普遍。当pSOFA分数呈下降趋势或保持不变时，热量和蛋白质摄入量高于呈上升趋势。
