Postpyloric vs gastric enteral nutrition in critically ill children: A single-center retrospective cohort study.

Background: We aimed to describe enteral nutrition (EN) delivery in patients receiving postpyloric EN (PPEN) vs gastric EN (GEN).

Methods: Single-center retrospective study including patients aged <21 years admitted to an intensive care unit in a pediatric quaternary care hospital for ≧48 h who received PPEN or GEN as a first approach, as guided by a nutrition algorithm. PPEN patients were 1:1 propensity score matched to GEN patients on demographics, clinical characteristics, and disease severity.

Impact of implementing an evidence-based definition of enteral nutrition intolerance on nutrition delivery: A prospective, cross-sectional cohort study.

Background: Enteral nutrition (EN) interruptions because of EN intolerance impede nutrient delivery. We aimed to examine whether revising the EN intolerance definition of an algorithm would decrease EN interruptions and improve nutrient delivery in critically ill children.

Methods: We performed a cross-sectional cohort study including patients who were admitted to our intensive care unit (ICU) for >24 h and received EN.

In-Hospital Cardiac Arrest in Adult Patients Admitted to a Quaternary Children's Center.

Objective: This study aimed to describe baseline and event characteristics and outcomes for adult patients who experience in-hospital cardiac arrest (IHCA) in a quaternary children's hospital and compare IHCA outcomes in younger (18-24 years) versus older (≥25 years) adults. We hypothesized that the rate of survival to hospital discharge would be lower in the older adult group.

Methods: We performed a retrospective single-center cohort study of inpatient areas of a quaternary children's center.

Association Between Anticholinergic Drug Burden and Adequacy of Enteral Nutrition in Critically Ill, Mechanically Ventilated Pediatric Patients.

Objectives: Enteral nutrition delivery is limited by intolerance and interruptions in critically ill children. Anticholinergic properties of frequently administered medications may contribute to altered gastric motility and enteral nutrition intolerance in this population. We examined the association between the anticholinergic burden of administered medications using the Anticholinergic Drug Scale and adequacy of enteral nutrition delivery.

Exposure to Anticholinergic Medications in Pediatric Severe Sepsis and Feasibility of Delirium Screening.

In sepsis, anticholinergic dysregulation may result in encephalopathy or delirium during severe illness, either as a result of central inflammation or because of exposure to medications with anticholinergic activity. In this retrospective study, we determined the magnitude of anticholinergic drug exposure in 75 children with severe sepsis. We found that exposure over the first 5 days was high-median (interquartile range) daily anticholinergic drug scale score 4 (2-5)-and associated with higher vasoactive scores and death.

Current State of Nutrition Education in Pediatric Critical Care Medicine Fellowship Programs in the United States and Canada.

Objectives: To assess the current state of nutrition education provided during pediatric critical care medicine fellowship.

Design: Cross-sectional survey.

Setting: Program directors and fellows from pediatric critical care medicine fellowship programs in America and Canada.

Bedside Postpyloric Tube Placement and Enteral Nutrition Delivery in the Pediatric Intensive Care Unit.

Background: Enteral nutrition (EN) delivery may be more effective via a postpyloric (PP) feeding tube in critically ill children, but tube placement can be challenging. We aimed to describe PP tube placement and EN practices in a multidisciplinary pediatric intensive care unit (PICU) after the implementation of a nurse-led bedside PP tube-placement program.

Methods: In a single-center retrospective study, we identified 100 consecutive patients admitted to the PICU for >48 hours and for whom PP tube placement was attempted.