Nutritional Intake in Venovenous ECMO Patients: A Single-Center Study in a North American PICU

Nutrients. 2024 Nov 7;16(22):3813. doi: 10.3390/nu16223813.

Abstract

Background/objectives: Multiple independent variables were analyzed to determine total nutritional intake (caloric and protein), while reviewing vasoactive inotrope scores (VISs).

Methods: Retrospective data were collected for nutritional intake (N = 64), daily VISs, extracorporeal membrane oxygenation (ECMO) complications, delays in nutritional intake (>48 h), reason for delay, and interruptions in nutrition support.

Results: VISs and ECMO characteristics analyzed by box-whisker plots demonstrated that ECMO complications prior to 24 h, cardiac arrest 24 h prior to ECMO, pediatric ECMO patients, venoarterial ECMO type, having a cardiac ECMO indication, and ECMO centrifugal pump had higher VISs. A regression analysis revealed that venovenous ECMO patients and the centrifugal pump type had higher caloric and protein intake; subsequently, for each increase in VIS, caloric intake decreased by -0.54. Sixteen patients did not receive nutritional support while on ECMO (9/16; 56% cardiac); 12/48 (25%) had a delay, with the cardiac patients nearing statistical significance.

Conclusion: Venovenous ECMO (non-cardiac) correlated with higher nutritional intake. The enteral administration of nutrition had a lower VIS on average compared to the other three groupings, namely enteral vs. parenteral; enteral vs. both enteral and parenteral; enteral vs. no nutrition. This study provides additional clinical insight on nutritional intake in ECMO patients.

Keywords: critical care; delay and interruption of nutritional support; extracorporeal membrane oxygenation; feeding tolerance; nutritional support; pediatric intensive care unit; pediatric nutrition; vasoactive inotrope score; venarterial; venovenous.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Dietary Proteins / administration & dosage
  • Energy Intake*
  • Enteral Nutrition / methods
  • Extracorporeal Membrane Oxygenation*
  • Female
  • Humans
  • Infant
  • Intensive Care Units, Pediatric*
  • Male
  • Nutritional Status
  • Nutritional Support / methods
  • Parenteral Nutrition
  • Retrospective Studies

Substances

  • Dietary Proteins

Grants and funding

This research received no external funding.