Challenges in Optimal Nutritional Care in Critically Ill Children in PICU - a Developing World Perspective

Abstract

In critically ill children, nutritional support remains a glaring challenge in resource-limited settings, which may be a contributor towards poor outcomes in the very sick children managed in the Paediatric Intensive Care Units (PICUs). To develop educational programs and hospital protocols towards optimal nutrition care of the very sick children, knowledge of the current trends, practices and significant challenges becomes the primary need. This study is aimed to review the current practices and challenges to optimal feeding in the ICUs. We plan to conduct a retrospective study on the feeding patterns of children aged 0 months to 14 years admitted to the Paediatric Intensive Care Unit (PICU) within the first 7 days of admission, at the Kijabe Mission Hospital. Data will be collected using a pre-prepared checklist from the Health Management Information System. The aim is to identify the gaps and challenges towards optimal feeding, if any, and optimize the feeding practices to meet international standards. We will conduct a census for three months; therefore enrol all patients admitted at PICU, within the determined three-month time frame. As evidence of numbers of patients presenting to KMH who receive intensive care is limited, based on daily ward round estimations, we will enrol approximately 75 patients into the study. As mentioned, the exact number depends on the number of patients presenting, and meeting study inclusion criteria during the three months of study enrolment. Frequencies of the baseline characteristics will be generated. For the primary analysis we will conduct a univariate logistic regression analysis where we will assess the association between each variable and outcome. Variables whose association with outcome will have a p-value less than 0.05 will be included in the multivariate analysis. All analyses will be done using SPSS software version 19. The main risks are the breach of confidentiality of patient records during the proposed research and invasion of patient privacy. There are no physical risks involved. All data will be collected after approval from the KNH/UoN - ERC and the KMH administration.