Abstract P-250: NUTRITION SUPPORT AND USE OF VASOACTIVE DRUGS IN CHILDREN RECEIVING ECMO

Abstract

Aims & Objectives: Adequate nutrition support (NS) is important in children receiving extracorporeal membrane oxygenation (ECMO). The study aim was to assess NS and the use of enteral nutrition (EN) and vasoactive medications in children receiving ECMO. Methods Records of children (2/11–4/17) were reviewed. Data collected: type of ECMO, oxygenation index (OI) and vasoactive–inotropic score (VIS). Nutritional status assessed by weight for age (WFA: underweight), height for age (HFA: chronic malnutrition), and weight for height (WFH/BMI: acute malnutrition), z-scores by WHO and CDC. Caloric (CI) and protein (PRO) intakes recorded after ECMO. Energy and protein needs estimated by Schofield and the A.S.P.E.N. guidelines, respectively. Values are mean ± SE. Results Sixty-seven patients (35 M) were included; median (IQR 25th-75th) age was 6.7 (1.5–14) years, weight, 22 (11–44) kg. Fifty-five and 12 patients received VV and VA ECMO, respectively. OI, VIS, and albumin were 37 ± 3,18 ± 3, and 2.54 ± 0.11 mg/dl, respectively. ICU length of stay (LOS): 21 (13–50) days; Hospital LOS: 33 (20–73) days; ECMO duration: 8 (4–20) days. WFA, HFA, and WFH/BMI z scores: -0.56 ± 0.26, -0.65 ± 0.27, and -0.08 ± 0.19, respectively. The prevalence of underweight, chronic and acute malnutrition was 39%, 40%, and 27%, respectively. The proportion of patients receiving EN on days 1, 3, 5, and 7 of ECMO were: 15%, 51%, 60%, and 65%, respectively; (Day 1 vs. all, p < 0.005) and were correlated with the VIS (r= -0.98, p <0.05).Conclusions Malnutrition was prevalent at time of ECMO initiation. As VIS decreased, the proportion of EN support increased by day 7 after ECMO.