Nutrition practices and outcomes in patients with pediatric acute respiratory distress syndrome.

BACKGROUND: Pediatric acute respiratory distress syndrome (PARDS) remains a significant cause of morbidity and mortality. Evidence suggests enteral nutrition (EN) may be protective in critically ill children. METHODS: This is a retrospective cohort study comparing intubated patients with PARDS who received EEN and those who did not. We included patients aged 2 weeks to 18 years who could receive full nutrition enterally prior to their disease and excluded patients with cyanotic heart disease. Disease severity was captured with oxygenation index (OI), oxygen saturation index (OSI), and pediatric logistic organ dysfunction (PELOD-2). EEN was defined as having received ≥25% of the calculated energy goal enterally within the first 48 h of PARDS diagnosis. RESULTS: We included 151 patients. Adjusted for age, OI, and OSI, the EEN group had a lower PICU mortality rate (adjusted odds ratio [aOR] = 0.071; 95% CI, 0.009-0.542; P = 0.011), had a higher likelihood of PICU discharge (adjusted risk ratio = 1.79; 95% CI, 1.25-2.55; P = 0.001), and was more likely to have at least one ventilator-free day (aOR = 3.96; 95% CI, 1.28-12.22; P = 0.017). Adjusted for age and PELOD-2, a statistically significant association between the EEN group and lower PICU mortality (P = 0.033), shorter PICU LOS (P < 0.001), and more ventilator-free days (P = 0.037) persisted. CONCLUSION: Our study found that EEN was associated with superior mortality rates, PICU LOS, and ventilator-free days in patients with PARDS.