[Transpyloric enteral nutrition in critically-ill children (I): technic and indications].

Objective: To study the utility and efficacy of transpyloric enteral nutrition (TEN) in critically-ill children by analyzing the factors that determine enteral tolerance.

Patients And Methods: We performed a prospective, observational study between 1994 and 2002 of all critically-ill children admitted to our pediatric intensive care unit who received TEN. The indications for enteral nutrition, type of nutrition and its duration were studied.

Results: A total of 286 patients (8.4 % of patients admitted to the PICU in the study period), aged between 3 days and 17 years received TEN. Fifty-five children (19.2 %) were aged less than 1 month and 165 (27.7 %) were aged less than 6 months. Seventy percent received TEN exclusively. The most frequent indication for TEN was mechanical ventilation in 255 children (89.2 %). One hundred seventy-six patients (61.5 %) received TEN in the postoperative period after cardiac surgery. The mean duration of TEN was 15.4 25 days, the maximum volume of nutrition was 118.7 41 ml/kg/day, and the maximum caloric intake was 88.6 26.7 kcal/kg/day. During TEN, 227 patients received sedation (79.3 %), and 124 were administered muscle relaxants (43.3 %), with no increase in complications.

Conclusions: TEN is a useful method of nutrition in critically-ill children.