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Study: Children in ICU recover faster without nutrition

Children in ICU who did not receive extra nutritional supplements until a week after arrival fared better than children fed immediately.

By Stephen Feller

LEUVEN, Belgium, March 15 (UPI) -- Researchers in Belgium found the standard practice of feeding children as soon as they get to ICU to help them recover faster is wrong.

Critically ill children fared better when nutritional supplements were withheld for the first week of intensive care as compared to those fed immediately, in a recent study.

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The assumption, researchers said, is that children have been unable to eat by themselves and need food to regain strength. To do so, artificial nutrition is infused into the bloodstream to strengthen muscles, prevent complications and speed recovery.

The same University of Leuven researchers who led the new study showed artificial feeding should be delayed for adults in the ICU in two previous studies, making the new finding less surprising.

For the study, published in the New England Journal of Medicine, researchers recruited 1,440 critically ill children in Belgium, the Netherlands and Canada, giving 723 nutritional supplements within 24 hours of arrival at ICU while 717 did not receive the supplements until their eighth day in ICU.

The researchers report mortality was similar in both groups, however 18.5 percent of children in the early nutrition group developed a new infection, while just 10.7 percent of the late nutrition group had one. Length of stay in the unit was also shorter for children who were fed later, staying an average of 6.5 days, as compared to about 9.2 days for those fed early.

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Additionally, later feeding was associated with an earlier live discharge from ICU, shorter duration of mechanical ventilation, less risk of need for renal-replacement therapy and an overall shorter time in the hospital.

"The children who had built up a nutritional deficiency after receiving little to no feedings had fewer infections, less organ failure, and a quicker recovery than children who had been fed through the IV," Dr. Greet Van den Berghe, a professor at the University of Leuven, in a press release. "The effect was present in everyone, regardless of the type of disease, the children's age, or the hospital in which they were staying."

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