Abstract P-298: TIMELINESS OF AN ACCELERATED CALORIE-BASED ENTERAL NUTRITION PROTOCOL IN THE PAEDIATRIC INTENSIVE CARE UNIT

Abstract

Aims & Objectives: This study aimed to evaluate the timeliness of an accelerated calorie-based nursing-led enteral nutrition protocol in the paediatric intensive care unit (PICU). Methods A “before and after” study design was used. We compared the time taken to achieve targeted feeding goals and incidence of intolerance between patients on the previous protocol that was based on fluid requirement against a revised protocol based on both fluid and calorie requirement, together with faster feed escalation. Energy goals were calculated based on the Schofield equations and Dietary Reference Intakes. Comparison between continuous variables was performed using the Mann-Whitney U test. We used chi-2 tests to compare categorical variables. Statistical significance was taken as p < 0.05 for all tests. Results A total of 138 patients were included; 78 in the fluid-based protocol and 60 for the calorie-based protocol. The two groups did not differ in clinical characteristics. Patients were mostly aged <1 year (n=63, 45.7%) with a median weight of 9.5kg [Interquartile range (IQR) 5.3, 16.2]. Main cause for admission was respiratory (n=61, 44.2%). Time of initiation to target feeding goals was decreased from 18 (IQR 18, 20) to 12 (IQR 12, 16) hours (p<0.001) for 3hourly and 27 (IQR 24, 32) to 16 (IQR 15.3, 24) hours (p<0.01) for 4hourly feedings. There is no difference in gastrointestinal intolerance between both protocols.Conclusions The revised feeding protocol resulted in shorter duration of time to achieve goal feeds. The accelerated feeding schedule allowed most patients to achieve targeted feeding goals without significantly increasing incidence of gastrointestinal intolerance.