| ObjectiveCritically ill children often have malnutrition or a potential risk of malnutrition.The lack of nutritional treatment during hospitalization will lead to further deterioration of nutritional status and affect the clinical outcome of the children.This study will analyze the nutritional risk and nutritional treatment of critically ill children in PICU and their correlation with clinical outcomes,in order to provide a theoretical basis for reasonable nutritional treatment,so as to avoid the occurrence of adverse clinical outcomes in critically ill children.MethodsChildren admitted to the PICU from November 1,2018 to August 31,2019 were selected,while those admitted to PICU for less than 48 hours and reentry into PICU within 2 months were excluded,a total of 345 children were enrolled.The Screening Tool for the Assessment of Malnutrition in Pediatrics（STAMP）was used to screen nutrition risks for children within 48 hours of PICU admission.The clinical outcomes of children were counted,including the length of PICU hospitalization,total length of hospitalization,total cost of hospitalization,rate of mechanical ventilation and rate of nosocomial infection,mechanical ventilation duration,and mortality.Analyzed the effects of different nutritional risks on clinical outcomes.At the same time,the status of nutritional treatment of PICU was investigated,including the start time of nutritional treatment,the method of nutritional treatment and the specific amount of nutritional treatment.Analyzed the effects of unreasonable nutritional treatment on clinical outcomes.Results1.Nutritional risk screening of children in PICU240（69.6%）critically ill children in PICU were admitted at high risk of malnutrition,105（30.4%）children were at moderate risk,and no children at low risk.High nutritional risk increased the length of PICU hospitalization,the costs of total hospitalization,and the rates of mechanical ventilation for critically ill children.2.Analysis of nutritional treatment in PICU256（74.2%）children received enteral nutrition in PICU,14（4.0%）children received parenteral nutrition,13（3.8%）children received enteral and supplementary parenteral nutrition,40（11.6%）children ate normally,and 22（6.4%）children had no nutritional intake.246（71.3%）children received nutritional support within 48 hours,and the reasons for the delay of nutritional treatment were gastrointestinal intolerance（39.4%）,hemodynamic instability（27.5%）,mechanically ventilation（10.4%）,surgery（10.1%）,blood purification（7.7%）,and stress hyperglycemia（4.9%）.Compared with the early start of nutritional treatment,the delayed start of nutritional treatment increased the costs of hospitalization,and mortality in critically ill children（P<0.05）.Only 44（15.5%）children in PICU had a reasonable caloric intake,206（72.8%）children had insufficient calorie intake and 33（11.7%）children had excessive calorie intake.The protein intake of the critically ill children was 1.07±0.60 g·kg-1·d-1.233（82.3%）children did not get enough protein.The use of mechanical ventilation was the influential factor of insufficient protein intake.Inadequate caloric and protein intake can lead to increased hospital costs for children.Conclusions1.Most children with PICU are at high risk of malnutrition when they are admitted to hospital,and the high risk may lead to increase the length of PICU hospitalization,the costs of total hospitalization,and the rates of mechanical ventilation.2.Delays in the start of nutritional treatment can increase the hospitalization costs and mortality of children.3.Insufficient calories and protein intake during PICU can increase the hospitalization costs of children.So,there should be more attention to nutritional treatment for critically ill children,in order to improve the clinical outcome of children. |
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