The impact of nutritional status on morbidities in mechanically ventilated critically ill children in PICUs (1024.8)

Abstract

Mechanically ventilated children in pediatric intensive care units (PICUs) are at risk for hospital‐acquired infections (HAI) and prolonged hospitalizations. We performed a multicenter, international cohort study to determine the unique contribution of nutritional status to clinical outcomes in mechanically ventilated children in PICUs (N=1622). Nutritional status was 17.9% underweight (BMI Z score < ‐2), 54.2% normal weight (BMI Z score > ‐2 and <1), 14.5% overweight (BMI Z score > 1 and < 2), and 13.4% obese (BMI Z score > 2). Prevalence of HAI, length of stay, and ventilator‐free days (VFD) were evaluated using multivariate analyses, controlling for diagnosis, admission type, PICU location and size. Compared to normal weight, risk for HAI was significantly higher in underweight (OR 1.79; 95% CI 1.16, 2.75; p=.008), overweight (OR 1.34; 95% CI 1.04, 1.73; p=.02), and obese children (OR 1.50; 95% CI 1.09, 2.05; p=.01). Hazard ratios for hospital discharge were significantly lower among underweight (HR 0.71; 95% CI 0.61, 0.84; p<.001) and obese (HR 0.81; 95% CI 0.68, 0.96; p=.02) compared to normal weight children. Underweight was associated with significantly fewer VFD than normal weight (p<.001), overweight (p<.001), and obesity (p=.03). Nutritional status is an important contributor to morbidities in the PICU. Future studies exploring outcomes related to nutritional status during PICU admissions are needed.Grant Funding Source: Supported by the Jean Hankin Nutritional Epidemiology award from the Academy of Nutrition and Dietet