Nutritional Advancement in the Hospitalized Child After NPO: A Retrospective Cohort Study. Hosp Pediatr 2020 Jan;10(1):90-94
Date
12/29/2019Pubmed ID
31882443DOI
10.1542/hpeds.2019-0251Scopus ID
2-s2.0-85149101196 (requires institutional sign-in at Scopus site) 2 CitationsAbstract
OBJECTIVES: A clear-liquid diet is commonly used after a nil per os (NPO) order in children recovering from acute gastrointestinal (GI) illnesses. Our purpose for this study was to compare outcomes in patients receiving a clear-liquid diet after an NPO order with outcomes in those receiving a regular diet.
METHODS: In this retrospective cohort study, patients aged 1 to 18 years admitted to a tertiary care children's hospital between 2016 and 2017 were screened to identify those who had an NPO order placed for acute GI illnesses. Patients with complex medical needs, a feeding disorder, or chronic GI disorders were excluded.
RESULTS: Of 39 total patients, 17 (44%) received a clear-liquid diet after an NPO order. There was no difference in diet tolerance between patients receiving a clear-liquid diet and those receiving a regular diet on the basis of emesis in the first 12 hours (P = .40), pain scores after the first oral intake (P = .86), return to clear-liquid diet (P = .57), or return to NPO status (P > .99). Patients started on a clear-liquid diet had a longer length of stay (LOS) after diet initiation compared with those receiving a regular diet (median: 43.7 hours [interquartile range: 29.8-53.4] vs median: 20.8 hours [interquartile range 6.7-47.3]), both in the univariate analysis (P = .01) and after controlling for age, diagnosis category, and pain score before and after the first oral intake (P = .03).
CONCLUSIONS: Patients transitioned to a clear-liquid diet after NPO status have a longer LOS after the first oral intake independent of patient age, diagnosis, and pretransition abdominal pain. Both groups had similar diet tolerance, suggesting that transition to a regular diet after NPO status may decrease LOS without significant adverse effects.
Author List
Burek AG, Liljestrom T, Porada K, Matschull L, Pan A, Havens PL, Goday PSAuthors
Alina G. Burek MD Associate Professor in the Pediatrics department at Medical College of WisconsinPeter Havens MD Emeritus Professor in the Pediatrics department at Medical College of Wisconsin
Tracey H. Liljestrom MD Associate Professor in the Pediatrics department at Medical College of Wisconsin
Amy Y. Pan PhD Associate Professor in the Pediatrics department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Abdominal PainChild
Child, Hospitalized
Diet
Gastrointestinal Diseases
Hospitalization
Humans
Length of Stay
Retrospective Studies
