What does this research mean for the field?

Gastrointestinal symptoms such as abdominal distension, vomiting, and high gastric residual volume, along with specific clinical exposures, significantly reduce the likelihood of achieving enteral nutrition adequacy in critically ill children. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To determine clinical factors and gastrointestinal symptoms associated with enteral nutrition tolerance and develop an objective risk score for feeding adequacy in critically ill pediatric patients.

September 8, 2026Pediatric Critical Care Medicine

Enteral Nutrition Intolerance and Delivery Adequacy in Pediatric Critical Care: Development of a Score Using a 2018 Multinational Cohort Study Dataset

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Authors

EMEnid E. MartinezBoston Children's Hospital AAAlireza Akhondi‐AslBoston Children's Hospital DSDennis SimonUniversity of Pittsburgh

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Implication

Cohort study reveals that gastrointestinal symptoms delay enteral feeding adequacy in critically ill children, suggesting a novel scoring tool can track nutrition tolerance.

Key Points

To determine clinical factors and gastrointestinal symptoms associated with enteral nutrition tolerance and develop an objective risk score for feeding adequacy in critically ill pediatric patients.
Conducted a secondary analysis of a 2018 multinational cohort dataset across 77 pediatric intensive care units with eight or more beds in 17 countries.
Evaluated 1,838 mechanically ventilated children aged 1 month to 18 years who received enteral nutrition and had a stay of 3 or more days.
Assessed time to reach 60% enteral nutrition adequacy over the first 10 days using an extended multivariable Cox regression model with frailty.
Achieving 60% enteral nutrition adequacy was significantly impaired by abdominal distension (aHR, 0.11; 95% CI, 0.03–0.45; p = 0.002), high gastric residual volume (aHR, 0.30; 95% CI, 0.15–0.59; p < 0.0001), and vomiting/emesis (aHR, 0.49; 95% CI, 0.27–0.90; p = 0.021).
An enteral nutrition tolerance score based on clinical factors (age, opioid, vasopressor, and paralytic exposure) and symptoms (distension, vomiting, high residual volume, feeding days, bleeding) doubled the hazard of failing to reach 60% adequacy for every 10-point increase.

Cite This Study

Martinez et al. (2026) studied this question.

synapsesocial.com/papers/6aa0091858e84d0ff5b47be3 https://doi.org/10.1097/pcc.0000000000004021

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Implication

Cohort study reveals that gastrointestinal symptoms delay enteral feeding adequacy in critically ill children, suggesting a novel scoring tool can track nutrition tolerance.

Enteral Nutrition Intolerance and Delivery Adequacy in Pediatric Critical Care: Development of a Score Using a 2018 Multinational Cohort Study Dataset

Discussion

Member takes

Implication

Key Points

Cite This Study

Enteral Nutrition Intolerance and Delivery Adequacy in Pediatric Critical Care: Development of a Score Using a 2018 Multinational Cohort Study Dataset

Discussion

Member takes

Implication

Key Points

Cite This Study

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