Evaluating a Stepwise Enteral Nutrition Protocol and Its Impact on Outcomes in Critically Ill Children in Pediatric Intensive Care Units

What this Trial Is About

This research aims to evaluate the effectiveness and patient outcomes after introducing a stepwise enteral nutrition algorithm in the Pediatric Intensive Care Unit PICU. The study focuses on critically ill children, who are vulnerable to malnutrition due to limited body reserves and the stress of critical illness. The study compares outcomes before and after implementing this protocol to assess its impact on nutritional delivery and patient health. The study includes two phases a pre-implementation phase with 40 patients receiving standard nutritional care and a post-implementation phase with 40 patients managed under the new stepwise enteral nutritional algorithm. The algorithm guides nutritional assessment, feeding initiation within 4 hours of admission when possible, feeding advancement, and management of feeding intolerance symptoms such as vomiting, diarrhea, and abdominal distention. It also standardizes fasting times before procedures to reduce unnecessary interruptions. Participants will undergo nutritional assessments including weight and growth measurements and be monitored for time to start enteral feeding, time to reach energy goals, and frequency of feeding interruptions. Clinical outcomes such as length of PICU stay, duration of mechanical ventilation, and survival will also be recorded. Safety measures include monitoring feeding intolerance and aspiration risks. Data from both phases will be compared to evaluate the algorithms effect, with assessments continuing up to 28 days from admission.

Stepwise Enteral Nutritional Algorithm and Patient Outcomes in Pediatric Intensive Care Units