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Abstract Details

Effect of Nutrition Support Therapy on Outcomes in Children with Moderate to Severe Traumatic Brain Injury
Child Neurology and Developmental Neurology
P13 - Poster Session 13 (5:30 PM-6:30 PM)
5-004
Examine the effect of timing and quantity of nutrition support on long-term outcomes in pediatric traumatic brain injury (TBI) patients. 
TBI causes the body to enter a hypermetabolic and hypercatabolic state, resulting in increased nutritional needs. Past studies of adult TBI have identified an association between the amount of nutrition received and overall outcomes. 
A retrospective review was performed of patients 0-18 years presenting to level 1 trauma centers with moderate to severe TBI from January 2010 to January 2019. Children with abusive head trauma were excluded. The data included demographics, assessments on presentation, ICU course, presence of ileus, calories per day, and goal calories per day within the first 7 days post-injury. Descriptive statistics and regression modeling analyses were performed. Outcomes included mortality, ICU length of stay, and pediatric Glasgow Outcome Scale-Extended Pediatric Version (GOS-E Peds) at 12-18 months post-injury.
81 of 185 patients (44%) received nutrition within 7 days of injury.  61 received enteral nutrition (EN) only, 2 received total parenteral nutrition (TPN) only, and 18 received TPN+EN. Median time to initiation of nutrition was 2.6 days for EN and 3.0 days for TPN.  Seventeen (21%) patients met recommended goal calories.  A 30% increase in the daily minimum percent of goal calories was associated with a 1-point decrease in GOS-E Peds score.  The mean percent of goal calories achieved on day 7 was 33% greater in patients receiving TPN+EN versus patients receiving EN alone. No difference was observed in the rate of hospital acquired infections between patients receiving TPN+EN and EN alone, but patients receiving TPN+EN had first bowel movements an average of 1.3 days later than patients receiving EN alone. 
Maintaining moderate and severe TBI patients’ caloric intake as close to goal as possible within the first 7 days may improve outcomes in pediatric TBI. 
Authors/Disclosures
Chelsea G. McElroy
PRESENTER 		No disclosure on file
Katrina Peariso, MD, PhD No disclosure on file
No disclosure on file