Underweight Status Is an Independent Predictor of In‐Hospital Mortality in Pediatric Patients on Extracorporeal Membrane Oxygenation
| Autor: | Elisabeth Lee, Michael L. Green, Pilar Anton-Martin, Paul A. Nakonezny, Michael F. Papacostas |
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| Rok vydání: | 2017 |
| Předmět: |
Male
0301 basic medicine Pediatrics medicine.medical_specialty medicine.medical_treatment Medicine (miscellaneous) Child Nutrition Disorders law.invention Cohort Studies 03 medical and health sciences Extracorporeal Membrane Oxygenation 0302 clinical medicine law 030225 pediatrics Intensive care medicine Extracorporeal membrane oxygenation Humans Extracorporeal cardiopulmonary resuscitation Hospital Mortality Retrospective Studies 030109 nutrition & dietetics Nutrition and Dietetics business.industry Infant Newborn Infant Retrospective cohort study Odds ratio Intensive care unit Child Preschool Female Underweight medicine.symptom business Cohort study |
| Zdroj: | Journal of Parenteral and Enteral Nutrition. 42:104-111 |
| ISSN: | 1941-2444 0148-6071 |
| DOI: | 10.1177/0148607116673185 |
| Popis: | Background Malnutrition is associated with an increased risk of mortality in patients admitted to the intensive care unit. Children requiring extracorporeal membrane oxygenation (ECMO) support represent an extremely ill subset of this population. There is a lack of data on the impact of nutrition state on survival in this cohort. We examined the association between being underweight and in-hospital mortality among children supported with ECMO. Materials and methods This article reports on an observational retrospective cohort study performed among neonatal and pediatric patients supported with ECMO in a tertiary children's hospital from May 1996 through June 2013. Nutrition status on intensive care unit admission was defined with z scores on weight for length and body mass index. Results Patients (N = 491) had a median age of 31 days (interquartile range, 2-771): 24.4% were underweight, and 8.9% were obese. During ECMO support, 88.3% received total parenteral nutrition, and 30.3% received enteral nutrition. Median maximum energy intake while receiving ECMO was 82 kcal/kg/d (interquartile range, 54.7-105). Multiple logistic regression showed that underweight status was associated with increased predicted odds of in-hospital mortality when compared with normal weight (odds ratio: 1.99, 95% confidence interval: 1.21-3.25, P = .006). Other factors associated with increased odds of mortality included extracorporeal cardiopulmonary resuscitation and the need for continuous renal replacement therapy. Conclusion Underweight status was an independent predictor for in-hospital mortality in our cohort of pediatric ECMO patients. Prospective studies evaluating the impact of metabolic state of children on ECMO should further define this relationship. |
| Databáze: | OpenAIRE |
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