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Complications of transpyloric nutrition in children

European Journal of Clinical Nutrition volume 63, page 919 (2009)Cite this article

In the March 2008 issue of this journal, investigators from the Pediatric Intensive Care Unit (PICU) at Gregorio Maranon General University Hospital in Spain addressed the issue of safety of transpyloric enteral nutrition in critically ill children in a single center, prospective, cross sectional, observational trial (Lopez-Herce et al., 2008). The trial was performed over 10 years and included 526 patients admitted to a PICU. The objective of the study was to analyze the risk factors for gastrointestinal complications and adverse effects of transpyloric nutrition in critically ill children.

The group reported the incidence of gastrointestinal complications in patients fed with transpyloric enteral nutrition as 11.5%, though only 2.1% of patients required enteral nutrition to be suspended because of gastrointestinal complications. In one patient, death was related to the complications of transpyloric feeding. The most frequently identified risk factors for gastrointestinal complications were shock, acute renal failure, hypokalemia, hypophosphatemia, and use of dopamine, epinephrine or vecuronium. Stepwise multivariate logistic regression analysis identified shock, epinephrine infusion at a rate higher than 0.3 mg/kg/min and hypophosphatemia as the most important factors associated with gastrointestinal complications. The authors conclude that transpyloric nutrition can be considered safe in most PICU patients.

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References

  • Lopez-Herce J, Santiago MJ, Sanchez C, Mencia S, Carillo A, Vigil D (2008). Risk Factors for gastrointestinal complications in critically ill children with transpyloric enteral nutrition. Eur J Clin Nutr 62, 395–400.

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  1. Paediatric Intensive Care, Royal Brompton Hospital, London, UK

    V Sheward & T Adamovic

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  1. V Sheward
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  2. T Adamovic
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Correspondence to V Sheward.

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Sheward, V., Adamovic, T. Complications of transpyloric nutrition in children. Eur J Clin Nutr 63, 919 (2009). https://doi.org/10.1038/ejcn.2009.3

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  • DOI: https://doi.org/10.1038/ejcn.2009.3

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