The nutritional impact of a feeding protocol for infants on high flow nasal cannula therapy.

Autor: Walter S; Department of Pediatrics, University of Oklahoma Health Sciences Center, University of Oklahoma, Oklahoma City, Oklahoma, USA.; Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA., DeLeon S; Department of Pediatrics, University of Oklahoma Health Sciences Center, University of Oklahoma, Oklahoma City, Oklahoma, USA., Walther JP; Department of Pediatrics, University of Oklahoma Health Sciences Center, University of Oklahoma, Oklahoma City, Oklahoma, USA., Sifers F; Department of Pediatrics, University of Oklahoma Health Sciences Center, University of Oklahoma, Oklahoma City, Oklahoma, USA.; Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA., Garbe MC; Department of Pediatrics, University of Oklahoma Health Sciences Center, University of Oklahoma, Oklahoma City, Oklahoma, USA., Allen C; Department of Pediatrics, University of Oklahoma Health Sciences Center, University of Oklahoma, Oklahoma City, Oklahoma, USA.
Jazyk: angličtina
Zdroj: Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition [Nutr Clin Pract] 2022 Aug; Vol. 37 (4), pp. 935-944. Date of Electronic Publication: 2022 Jan 24.
DOI: 10.1002/ncp.10817
Abstrakt: Background: Clinicians may be reluctant to feed patients on high-flow nasal cannula (HFNC) therapy, despite studies suggesting it is beneficial and safe. We describe the implementation of a feeding protocol for patients with bronchiolitis on HFNC and determine its effect on nutrition goals.
Methods: Prospective bedside data on enteral volume, feed interruptions, and aspiration events were collected on patients with bronchiolitis who were <24 months of age, treated with HFNC, and fed per a developed protocol. Exclusion criteria included history of prematurity <32 weeks, congenital heart disease, or positive-pressure ventilation before feeding. Length of intensive care unit and hospital stay was compared with both a concurrent cohort (CC) of patients not fed per the protocol and a retrospective cohort (RC) admitted prior to protocol creation.
Results: Seventy-eight patients met the criteria for the prospective study arm: 24 patients were included in the CC, and 74 were included in the RC. Seventy-one percent of prospective patients received enteral nutrition (EN) on HFNC day 1 vs 42% of the CC. In the prospective cohort, feed interruption occurred in 23% of patients and was associated with higher flow rates; however, no aspiration events occurred. Patients fed per protocol were fed 8-10 h sooner and discharged 1 day earlier than those in the RC.
Conclusion: The use of a feeding protocol for patients with bronchiolitis on HFNC was safe and associated with shorter time to initiate EN and shorter length of hospital stay.
(© 2022 American Society for Parenteral and Enteral Nutrition.)
Databáze: MEDLINE
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