INTRODUCTION Malnutrition affects 50% of hospitalized children and 25-70% of critically ill children. Enteral tube feeding is generally considered the preferred modality for critically ill pediatric patients. Clinical advantages of using peptide-based formulas are still controversial in critically ill children. The aim of this study was to compare the effect of a peptide-based formula versus a standard polymeric formula on feeding tolerance and whether this will affect the outcome among critically ill children. MATERIAL AND METHODS This single blind case control study was conducted on 180 randomly selected critically ill children in the pediatric critical care unit (PICU) of Ain Shams University. Patients were divided into 2 groups: a group receiving a standard polymeric formula (group 1; 90 patients) and a group receiving a peptide-based formula (group II; 90 patients). Nutritional requirements, days to reach full enteral feeding, feeding intolerance symptoms and anthropometric measurements were recorded for all patients at admission together with their pediatric risk of mortality score (PRISM). Length of PICU stay, occurrence of sepsis together with survival were analyzed at discharge as outcome measures. RESULTS Patients receiving a peptide-based formula showed a significant decrease in feeding interruptions and abdominal distention (p < 0.000), reached full enteral feeding faster (2.60 ±0.74 days versus 5.36 ±1.00 days in patients received polymeric standard formula; p < 0.001) and improved weight gain (p < 0.028). Moreover, duration of sepsis was significantly shorter (p < 0.045), but no difference in mortality was recorded between patient groups. CONCLUSIONS Peptide-based formula feeding was better tolerated than standard polymeric formula feeding in critically ill pediatric patients. However, the choice of patients receiving the peptide-based formula needs to be further evaluated.

中文翻译：

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用于危重儿童的基于肽的配方与基于标准的聚合配方：它对患者的耐受性是否更好？

简介 营养不良影响着 50% 的住院儿童和 25-70% 的危重儿童。肠内管饲通常被认为是危重儿科患者的首选方式。在危重儿童中使用肽配方的临床优势仍然存在争议。本研究的目的是比较基于肽的配方奶粉与标准聚合配方奶粉对喂养耐受性的影响，以及这是否会影响危重儿童的结果。材料和方法 这项单盲病例对照研究是对艾因夏姆斯大学儿科重症监护病房 (PICU) 中随机选择的 180 名危重儿童进行的。患者被分为 2 组：接受标准聚合配方的组（第 1 组；90 名患者）和接受基于肽的配方的组（第 II 组；90 名患者）。记录所有患者入院时的营养需求、达到完全肠内喂养的天数、喂养不耐受症状和人体测量值以及儿科死亡风险评分 (PRISM)。出院时分析 PICU 停留时间、脓毒症发生率以及生存率作为结果指标。结果 接受肽配方奶粉的患者喂养中断和腹胀显着减少 (p < 0.000)，更快地达到完全肠内喂养（2.60 ±0.74 天，而接受聚合物标准配方奶粉的患者为 5.36 ±1.00 天；p < 0.001）并改善体重增加（p < 0.028）。此外，败血症的持续时间显着缩短（p < 0.045），但患者组之间的死亡率没有差异。结论 对于危重儿科患者，基于肽的配方奶喂养比标准聚合配方奶喂养的耐受性更好。然而，接受肽配方的患者的选择需要进一步评估。