Daily Nutritional Intake of Pediatric Patients (N = 64) on Extracorporeal Membrane Oxygenation from 2018 to 2022: A Single-Center Report.
Megan BrackmannAnnika LintvedtBenjamin KogelschatzErika HeinzeJessica L ParkerKaren FergusonElizabeth RosnerBrian BovilleMara L Leimanis-LaurensPublished in: Nutrients (2023)
Nutrition in pediatric populations who require life-saving extracorporeal membrane oxygenation (ECMO) remains a debate. We sought to identify if nutritional needs were met in a patient cohort. A retrospective chart review of patients (N = 64) requiring ECMO at Helen DeVos Children's Hospital between 2018 and 2022 was evaluated for demographics, daily nutritional data, laboratory values, ECMO complications, and outcome data, with primary outcome measures of percent protein and percent caloric intake. Secondary outcome measures included the intensive care unit length of stay, time on ECMO, mortality, and day 1 severity of illness scores (Pediatric Logistic Organ Dysfunction). The timeline partially overlapped with the COVID-19 pandemic. Data were collected for 467 ECMO days with a median age of 2.6 months; 57.8% of patients were male and 65.6% were with one pre-existing comorbidity. Venoarterial (VA) ECMO was utilized in 84.4% of patients; the ECMO indication was cardiac in 53.1% of patients. The 28-day mortality was 43.8%. The proportion of days in which the caloric goal was met was 0%; the proportion of days in which protein goals were met was 33.3%. Non-cardiac ECMO patients had a greater number of days where caloric goals were met ( p -value = 0.04). Mortality at 28 days was not statistically significant ( p -value = 0.28) for calories or protein administered. The patient cohort struggled to meet calorie and protein goals while on ECMO.
Keyphrases
- extracorporeal membrane oxygenation
- acute respiratory distress syndrome
- end stage renal disease
- ejection fraction
- newly diagnosed
- chronic kidney disease
- peritoneal dialysis
- physical activity
- type diabetes
- cardiovascular disease
- young adults
- emergency department
- heart failure
- case report
- patient reported outcomes
- cardiovascular events
- left ventricular
- electronic health record
- binding protein
- small molecule
- coronary artery disease
- patient reported
- protein protein
- amino acid
- weight loss