Early vs late enteral nutrition in pediatric intensive care unit: Barriers, benefits, and complications

Background This study aimed to define the existing barriers for early enteral nutrition (EEN) in critically ill children and to analyze the differences in nutrient supply, complications, and outcomes between EEN and late EN (LEN). Methods This is a secondary analysis of a multicenter observational, prospective study including critically ill children receiving EN. Variables analyzed included demographic and anthropometric features, caloric and nutrient supply, outcomes, and complications according to the EN onset. Patients were classified into two groups according to the start of EN: 24‐EEN vs EN started after 24 h (24‐LEN) and 48‐EEN vs EN started after 48 h (48‐LEN). Results Sixty‐eight children were enrolled; 22.1% received 24‐EEN, and 67.6% received 48‐EEN. EN was most frequently delayed in patients older than 12 months, in patients with cardiac disease, and in those requiring mechanical ventilation (MV). Children in the 24‐EEN group had shorter duration of MV compared with those in the 24‐LEN group (P = 0.04). The 48‐EEN group received a higher caloric intake (P = 0.04), reached the caloric target earlier (P