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The effect of high fat dietary modification and nutritional status on the outcome of critically ill ventilated children: single-center study

BACKGROUND: Ventilator dependency constitutes a major problem in the intensive care setting. Malnutrition is considered a major determinant of extubation failure, however, attention has been attracted to modulating carbon dioxide production through decreasing carbohydrate loading and increasing the...

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Autores principales: El Koofy, Nehal Mohamed, Rady, Hanaa Ibrahim, Abdallah, Shrouk Moataz, Bazaraa, Hafez Mahmoud, Rabie, Walaa Ahmed, El-Ayadi, Ahmed Ali
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Pediatric Society 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6753313/
https://www.ncbi.nlm.nih.gov/pubmed/30999727
http://dx.doi.org/10.3345/kjp.2018.06835
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author El Koofy, Nehal Mohamed
Rady, Hanaa Ibrahim
Abdallah, Shrouk Moataz
Bazaraa, Hafez Mahmoud
Rabie, Walaa Ahmed
El-Ayadi, Ahmed Ali
author_facet El Koofy, Nehal Mohamed
Rady, Hanaa Ibrahim
Abdallah, Shrouk Moataz
Bazaraa, Hafez Mahmoud
Rabie, Walaa Ahmed
El-Ayadi, Ahmed Ali
author_sort El Koofy, Nehal Mohamed
collection PubMed
description BACKGROUND: Ventilator dependency constitutes a major problem in the intensive care setting. Malnutrition is considered a major determinant of extubation failure, however, attention has been attracted to modulating carbon dioxide production through decreasing carbohydrate loading and increasing the percent of fat in enteral feeds. The detected interrelation between substrate oxidation and ventilation outcome became the base of several research to determine the appropriate composition of the nonprotein calories of diet in ventilated patients. PURPOSE: We aimed to assess the effect of high-fat dietary modification and nutritional status on ventilatory and final outcomes of pediatric intensive care. METHODS: Fifty-one ventilated children (1 month to 12 years of age) with pulmonary disease who could be enterally fed, in the Cairo University Pediatric intensive care unit, were divided into 2 groups: group A included 25 patients who received isocaloric high-fat, low-carbohydrate diet; group B included 26 patients who received standard isocaloric diet. Comprehensive nutritional assessment was done for all patients. RESULTS: Group A had a significant reduction in carbon dioxide tension, but no similar reduction in the duration or level of ventilatory support. Assisted minute ventilation was predicted by weight-for-age and caloric intake rather than the type of diet. Poor nutritional status was associated with higher mortality and lower extubation rates. Mild hypertriglyceridemia and some gastrointestinal intolerance were significant in group A, with no impact on the adequacy of energy or protein delivery. CONCLUSION: The high-fat enteral feeding protocol may contribute to reducing carbon dioxide tension, with mild hypertriglyceridemia and negligible gastrointestinal intolerance as potential adverse effects. Optimization of nutritional status rather than dietary modification may improve ventilatory and survival outcomes in critically ill-ventilated children.
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spelling pubmed-67533132019-09-25 The effect of high fat dietary modification and nutritional status on the outcome of critically ill ventilated children: single-center study El Koofy, Nehal Mohamed Rady, Hanaa Ibrahim Abdallah, Shrouk Moataz Bazaraa, Hafez Mahmoud Rabie, Walaa Ahmed El-Ayadi, Ahmed Ali Korean J Pediatr Original Article BACKGROUND: Ventilator dependency constitutes a major problem in the intensive care setting. Malnutrition is considered a major determinant of extubation failure, however, attention has been attracted to modulating carbon dioxide production through decreasing carbohydrate loading and increasing the percent of fat in enteral feeds. The detected interrelation between substrate oxidation and ventilation outcome became the base of several research to determine the appropriate composition of the nonprotein calories of diet in ventilated patients. PURPOSE: We aimed to assess the effect of high-fat dietary modification and nutritional status on ventilatory and final outcomes of pediatric intensive care. METHODS: Fifty-one ventilated children (1 month to 12 years of age) with pulmonary disease who could be enterally fed, in the Cairo University Pediatric intensive care unit, were divided into 2 groups: group A included 25 patients who received isocaloric high-fat, low-carbohydrate diet; group B included 26 patients who received standard isocaloric diet. Comprehensive nutritional assessment was done for all patients. RESULTS: Group A had a significant reduction in carbon dioxide tension, but no similar reduction in the duration or level of ventilatory support. Assisted minute ventilation was predicted by weight-for-age and caloric intake rather than the type of diet. Poor nutritional status was associated with higher mortality and lower extubation rates. Mild hypertriglyceridemia and some gastrointestinal intolerance were significant in group A, with no impact on the adequacy of energy or protein delivery. CONCLUSION: The high-fat enteral feeding protocol may contribute to reducing carbon dioxide tension, with mild hypertriglyceridemia and negligible gastrointestinal intolerance as potential adverse effects. Optimization of nutritional status rather than dietary modification may improve ventilatory and survival outcomes in critically ill-ventilated children. Korean Pediatric Society 2019-09 2019-04-02 /pmc/articles/PMC6753313/ /pubmed/30999727 http://dx.doi.org/10.3345/kjp.2018.06835 Text en Copyright © 2019 by The Korean Pediatric Society This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
El Koofy, Nehal Mohamed
Rady, Hanaa Ibrahim
Abdallah, Shrouk Moataz
Bazaraa, Hafez Mahmoud
Rabie, Walaa Ahmed
El-Ayadi, Ahmed Ali
The effect of high fat dietary modification and nutritional status on the outcome of critically ill ventilated children: single-center study
title The effect of high fat dietary modification and nutritional status on the outcome of critically ill ventilated children: single-center study
title_full The effect of high fat dietary modification and nutritional status on the outcome of critically ill ventilated children: single-center study
title_fullStr The effect of high fat dietary modification and nutritional status on the outcome of critically ill ventilated children: single-center study
title_full_unstemmed The effect of high fat dietary modification and nutritional status on the outcome of critically ill ventilated children: single-center study
title_short The effect of high fat dietary modification and nutritional status on the outcome of critically ill ventilated children: single-center study
title_sort effect of high fat dietary modification and nutritional status on the outcome of critically ill ventilated children: single-center study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6753313/
https://www.ncbi.nlm.nih.gov/pubmed/30999727
http://dx.doi.org/10.3345/kjp.2018.06835
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