Background and objectives: Nutrition is a fundamental component of care of critically ill children. Determining variation in nutritional practices within paediatric intensive care units (PICUs) allows for review and improvement of nutrition practices.
Methods and study design: The aim was to survey the nutrition practices and perspectives of paediatric intensivists and dieticians in Asia-Pacific and the Middle East. A questionnaire was developed to collect data on (1) the respondent's and institution's characteristics, (2) nutritional assessments and nutrient delivery practices, and (3) the perceived importance and barriers to optimal enteral feeding in the PICU.
Results: We analysed 47 responses from 35 centres in 18 different countries. Dedicated dietetic services were only present in 13 (37%) centres and regular nutrition assessments were conducted in only 12 (34%) centres. In centres with dedicated dieticians, we found greater use of carbohydrate, fat additives and special formulas. Two thirds [31 (66%)] of respondents used total fluids to estimate energy requirements. Only 11 (31%) centres utilized feeding protocols. These centres had higher use of small bowel feeding, acid suppressants, laxatives and gastric residual volume thresholds. When dealing with feed intolerance, they were also more likely to start a motility agent. There was also a lack of consensus on when feeding should start and the use of adjuncts.
Conclusions: Nutrition practices and barriers are unique in Asia-Pacific and the Middle East and strongly reflect a lack of dietetic services. Future effort should focus on developing a uniform approach on nutrition practices to drive paediatric critical care nutrition research in these regions.
背景与目的：营养是危重患儿护理的一个基本组成部分。确定儿科重症监护 病房内的营养实践变化（PICUS），从而评估和改善营养实践。方法与研究设 计:目的是调查亚太和中东地区的营养实践和儿科重症监护室及营养师的观 点。设计调查问卷，收集以下数据：（1）受访者及机构的特点；（2）营养评 估和营养输送的方法；（3）PICU 最佳喂养的重要性和障碍。结果：分析了来 自18 个国家， 35 个中心的47 名受访者的资料。只有13（37%）个中心有专 门的饮食服务，12（34%）个中心有正规的营养评估。在有专门营养师的中 心，我们发现更多使用碳水化合物、脂肪添加剂和特殊配方。2/3（31， 66%）的被调查者使用全流体来估算能量需求。只有11（31%）个中心使用喂 养计划。这些中心常使用小肠喂养、酸抑制剂、泻药和胃残留量阈值。在处理 食物不耐受时，他们更可能一开始就使用蠕动剂。关于什么时候开始喂养以及 添加什么辅食方面缺乏共识。结论：亚太和中东地区独特的营养行为和障 碍，强烈反映了饮食服务的缺乏。未来的努力应该集中在发展统一的营养实践 方法，推动这些地区儿科重症监护的营养学研究。.