Nutritional Screening and Enteral Feeding Timing in Critically-Ill Children: Insights from STRONGkids and a Prospective Study in Egypt | ||||
| The Egyptian Journal of Hospital Medicine | ||||
| Article 182, Volume 100, Issue 1, July 2025, Page 3821-3824 PDF (622.09 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejhm.2025.449120 | ||||
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| Abstract | ||||
| Background: Malnutrition is a major concern in children in paediatric intensive care units (PICUs) who are in serious condition. It worsens during hospitalization due to metabolic stress and inadequate feeding, predisposing children to infections, delayed recovery, and poor outcomes. Early enteral nutrition (EN) has been linked to improved outcomes, but implementation remains inconsistent, especially in resource-limited settings. Objective: This study aimed to assess nutritional risk among critically-ill pediatric patients using the STRONGkids tool upon PICU admission, and to compare nutritional outcomes between early (within 24–48 hours) and delayed (> 48 hours) initiation of enteral nutrition. Methods: A prospective observational study was conducted in a tertiary PICU in Egypt over six months. Fifty critically-ill children (aged 1 month–15 years) were enrolled and divided equally into early and delayed EN groups. Nutritional risk was screened at admission using the STRONGkids tool. Nutritional outcomes included time to full caloric intake, frequency of feeding interruptions, weight changes, and biochemical markers [serum albumin, total protein, and C-reactive protein (CRP)]. Results: STRONGkids identified a high prevalence of nutritional vulnerability: 64% high risk, 30% moderate risk, and only 6% low risk. Nutritional outcomes significantly favored the early EN group: faster attainment of caloric goals (median 2 vs. 6 days, p < 0.001), fewer feeding interruptions (20% vs. 72%, p < 0.001), greater weight gain (0.8 ± 0.2 vs. 0.1 ± 0.1 kg, p < 0.01), higher serum albumin (3.9 ± 0.3 vs. 2.8 ± 0.4 g/dL, p < 0.01), higher total protein (6.8 ± 0.5 vs. 5.2 ± 0.8 g/dL, p < 0.01), and lower CRP (12.5 ± 5.1 vs. 45.3 ± 18.7 mg/L, p < 0.01). Conclusion: STRONGkids proved valuable for early detection of malnutrition risk in PICU patients. Early EN within 24–48 hours led to markedly better nutritional outcomes compared with delayed feeding, highlighting the importance of structured screening and timely nutritional intervention. | ||||
| Keywords | ||||
| Early enteral nutrition; Delayed feeding; Critically-ill pediatric patients; PICU; nutritional outcomes; Infection | ||||
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