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Enteral Nutrition Practices during Non-invasive Ventilation in Critically Ill Children: Secondary Analysis of the NIV Dex EN Study
Journal article   Open access   Peer reviewed

Enteral Nutrition Practices during Non-invasive Ventilation in Critically Ill Children: Secondary Analysis of the NIV Dex EN Study

Charlene P. Pringle, Peter Chang, Joie Cavazos, Tristan Dorn, Christine Allen, K. Leslie Avery, Torrey Baines, Samantha Gee, Nekaiya Jacobs, Jodi J. Bloxham, …
Journal of pediatric intensive care, Vol.15(1), 9
09/02/2026
DOI: 10.53391/2146-4618.1082
url
https://doi.org/10.53391/2146-4618.1082View
Published (Version of record) Open Access

Abstract

Introduction: Despite the widespread use of non-invasive ventilation (NIV) in pediatric intensive care units (PICUs), little has been published regarding enteral nutrition (EN) in this setting. This pre-planned secondary analysis of the Association of Enteral Nutrition and Dexmedetomidine Usage for Critically Ill Children Requiring Non-Invasive Ventilation study aimed to describe current feeding practices during NIV in a large sample, including differences in timing, energy and protein delivery across NIV modes and interfaces. Methods: Secondary analysis of a retrospective study of 1763 patients acutely supported with NIV over one year in fourteen PICUs in the United States. Results: 1065 subjects (60.4%) received EN, with younger children fed vs not fed (median [IQR] 12 months [4,72] vs 24 months [9,96], p<0.001). The overall median (IQR) of energy delivered as a percentage of the goal was 105% (79,121). The overall median (IQR) of the protein delivered was 79% (61,86) of the benchmark. Most were fed via gastric route [50% PO (including 5% breastfed), 20% NG and 16.5% GT] vs. 13.5% post-pyloric. Both NIV interface (p<0.001) and modality (p<0.001) were associated with timing of initiation of EN. NIV failure rate was higher in those not fed n=76 (10.8%) vs n=24(2.2%); p<0.0001. Conclusion: In this large sample exploring current practices of EN provided during NIV support in pediatric ICUs, the majority of children were fed. Documenting this prevalence highlights the need for development of feeding pathways or protocols for critically ill children acutely supported with NIV, as well as provides background for future research foci.
 Critical Care Intensive care units Pediatric Non-invasive ventilation Enteral nutrition

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