Nutritional assessment as standard of care on a pediatric intensive care unit; does it work?

Background & aims: Critically ill children are at risk of developing malnutrition when receiving intensive care, especially those with digestive tract problems. This study aimed to evaluate the feasibility of nutritional assessment by means of anthropometric measurements to monitor children with major congenital anomalies of the digestive tract. Methods: Children with congenital anomalies of the digestive tract, receiving intensive care for more than 3 days, were scheduled for weekly nutritional assessment by two anthropometrists (available for 0.4 fte). Numbers of actual measurements per patient and success rate of the individual anthropometric measurement techniques were evaluated. Reasons for missed measurements were evaluated in a separate population. Results: Of the 89 children included, 54 (61%) underwent nutritional assessment. No more than eight (15%) had been assessed at the proposed frequency. All applied separate nutritional assessment techniques had a success rate of 100%. Twenty six percent of the missed assessments were due to unavailability of the anthropometrists, and 8% to children's bad condition. Conclusions: Regular nutritional assessment in the current setting was not feasible. Adequate monitoring of nutritional status in critically ill children calls for weekly assessment. An adequate infrastructure, which guarantees structural availability of trained personnel, is the cornerstone in this setting.

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