Skip Navigation LinksHome > May 2012 - Volume 54 - Issue 5 > Factors Associated With Peptide-based Formula Prescription i...
Journal of Pediatric Gastroenterology & Nutrition:
doi: 10.1097/MPG.0b013e31824a0149
Original Articles: Hepatology and Nutrition

Factors Associated With Peptide-based Formula Prescription in a Pediatric Intensive Care Unit

Vidigal, Maria V.M.*; Leite, Heitor P.; Nogueira, Paulo C.K.

Collapse Box

Abstract

Objectives: There is no evidence-based consensus on the use of peptide-based formulas for critically ill children. The present study aimed to identify the factors associated with the choice of peptide-based formulas in the first enteral nutrition prescription for critically ill children and to compare the direct costs of the enteral formulas used in a pediatric intensive care unit.

Methods: In a prospective study, children admitted to the intensive care unit and receiving tube feeding for ≥48 hours were evaluated. The potential exposure variables for the use of peptide-based formulas as the first nutrition prescription were age, sex, malnutrition, sepsis/septic shock, fasting period >2 days, use of α-adrenergic drugs before initiating first diet, and the revised Pediatric Index of Mortality score. A direct cost comparison of prescribed formulas was performed.

Results: Of 291 patients included, 85 (29.2%) were given peptide-based formulas in the first nutrition prescription. This choice was independently associated with malnutrition (odds ratio [OR] 2.94; 95% confidence interval [CI] 1.60%–5.39%; P < 0.01), fasting period >2 days (OR 3.46; 95% CI 1.93%–6.20%; P < 0.01), and use of α-adrenergic drugs (OR 2.32; 95% CI 1.24%–4.31%; P < 0.01). Peptide-based formula costs were up to 10 times higher than standard polymeric formula costs.

Conclusions: The choice of peptide-based formula as the first enteral nutrition prescription is associated with the greater severity of patients’ clinical status—patients receiving α-adrenergic drugs, those who are malnourished, and those with longer fasting periods. These prescriptions engender costs higher than those associated with standard polymeric formula.

Copyright 2012 by ESPGHAN and NASPGHAN

Login

Article Tools

Share

Article Level Metrics

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.

Connect With Us

 

 

Twitter

twitter.com/JPGNonline