Early Enteral Feeding in the Pediatric Intensive Care Unit

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Abstract
Background: The purpose of this study was to evaluate the feasibility and safety of early enteral feedings of critically ill pediatric patients. Methods: The subject population of 42 critically ill patients ranged in age from 5 days to 18 years (mean 5.8 years), mean weight 17 kg. Transpyloric nasoenteric tubes were placed in all patients by a nonfluoroscopic bedside technique. All subjects were mechanically ventilated; 32 (76%) were on one or more vasoactive medications. Six (15%) patients were fed for more than 13 days while on vasoactive support and pharmacological paralysis. Results: There were no documented complications of early enteral feeding, including aspiration. All patients were able to achieve caloric goals within 48 hours of beginning enteral feedings. All patients developed regular stool patterns despite periodic absence of bowel sounds. Enteral feedings replaced 256 days of total parenteral nutrition. Estimated patient charge savings averaged $425 for each day of enteral feedings. Conclusions: Early enteral feedings are feasible, well tolerated, and cost effective in critically ill pediatric patients. (Journal of Parenteral and Enteral Nutrition 20:71-73, 1996)