PP258-MON: Are Linoleic and Alpha-Linolenic Acids Essential? Observations in an Infant with Apoprotein-C2 Deficiency

Abstract

Rationale: In critically ill children, an optimal energy and protein intake is associated with decreased mortality and morbidity. However, both the prescription of nutrition and its administration are complex and may be limited by several barriers. These aspects of nutritional support have been poorly studied in this population. The aims of this pilot study were to determine the amount of nutrition prescribed and delivered to children in comparison with their nutritional requirements. Methods: In this prospective study, critically ill children hospitalized for >24 hours in pediatric intensive care unit and without oral nutritional intake at admission were consecutively included. The total amounts of energy and protein prescribed and delivered were recorded daily until the 10th day of hospitalization, discharge or death. Energy and protein requirements were, respectively, calculated with the Schofield equation (+20% when extubated) and ASPEN guidelines. The ratios prescribed/requirements and delivered/requirements were calculated on day 3, 5 and on the last day. Results: We included 64 children with a median age of 2.7 years [Interquartile range: 0.4 5.7] and a length of stay of 7 days [IQR: 4 10]. Nutritional support was introduced in 88% of patients within 22 hours [IQR 13 29]. Eighty-one percent of children received enteral nutrition for a period of 5±2.4 days. The ratios energy and protein prescribed/requirements at the three studied days were respectively of 104±52%, 110±43%, 116±57% and 63±42%, 84±39%, 90±43%. The ratios energy and protein delivered/requirements were respectively 90±56%, 103±52%, 110±58% and 59±40%%, 83±45%, 84±42%. Conclusion: This pilot study shows that prescriptions and nutrition delivered are close to energy requirements. Concerning protein, although the ratios increase during the stay, the ASPEN guidelines are difficult to satisfy.