Change in Nutritional Status of Children in the Pediatric Intensive Care Unit over First 14 Days: A Prospective Cohort Study.

BACKGROUND AND AIMS: We studied changes in nutritional status from baseline, as measured by serial skinfold thickness measurements and their association with patient factors, disease factors, and biochemical factors, as well as time to the start of enteral feeds. PATIENTS AND METHODS: We enrolled 50 consecutive children aged 2-5 years from the pediatric intensive care unit (PICU) of a public sector hospital in India between 14 February, 2024 and 31 August, 2024. Baseline demographic and clinical data were recorded. Serial anthropometric parameters were measured for all children at the time of admission (+4 hours), day 3, day 7, and day 14 or at hospital discharge, if earlier. We used the World Health Organization (WHO) growth charts to interpret the anthropometric data. RESULTS: Of the 50 children enrolled (mean age 3.17 ± 1.22 years; 46% females), 58% were underweight, 52% had wasting, and 52% had short stature at admission. Only 10% children (n = 5) had triceps skinfold thickness for age <-2 standard deviation (SD) at baseline. 32 (64%) of the children demonstrated a reduction in triceps skinfold thickness, 72% (n = 36) experienced weight loss, and 58% (n = 29) showed a decrease in mid-upper arm circumference (MUAC). However, we did not find a statistically significant association of change in triceps skinfold thickness with age, severity of illness, outcome, duration of stay, and early start of enteral feeds. CONCLUSION: This study shows the feasibility of skinfold calipers as a serial monitoring tool in the PICU. Nutritional status worsens during the initial 2 weeks of PICU stay, despite early enteral feeding policies.