1. Enteral nutrition protects children undergoing allogeneic hematopoietic stem cell transplantation from blood stream infections
- Author
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Andrea Pession, Arcangelo Prete, Maria Luisa Forchielli, Roberto Rondelli, Daniele Zama, Elena Biagi, Edoardo Muratore, Marco Candela, Riccardo Masetti, Zama D., Muratore E., Biagi E., Forchielli M.L., Rondelli R., Candela M., Prete A., Pession A., and Masetti R.
- Subjects
0301 basic medicine ,Adult ,Male ,medicine.medical_specialty ,Parenteral Nutrition ,Multivariate analysis ,Platelet Engraftment ,Adolescent ,medicine.medical_treatment ,Short Report ,Blood stream infections ,Medicine (miscellaneous) ,lcsh:TX341-641 ,Hematopoietic stem cell transplantation ,Clinical nutrition ,Gut microbiota ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Enteral Nutrition ,Postoperative Complications ,Internal medicine ,Sepsis ,medicine ,Humans ,Child ,lcsh:RC620-627 ,030109 nutrition & dietetics ,Nutrition and Dietetics ,business.industry ,Incidence (epidemiology) ,Hematopoietic Stem Cell Transplantation ,Infant ,Paediatrics ,Blood stream infection ,lcsh:Nutritional diseases. Deficiency diseases ,Parenteral nutrition ,Treatment Outcome ,Italy ,Paediatric ,030220 oncology & carcinogenesis ,Child, Preschool ,Female ,business ,Body mass index ,Blood stream ,lcsh:Nutrition. Foods and food supply - Abstract
Enteral Nutrition (EN) is recommended as first line nutritional support for patients undergoing Allogeneic Hematopoietic Stem Cell Transplantation (allo-HSCT), but only few studies exist in the literature which compare EN to Parenteral Nutrition (PN) in the paediatric population.Forty-two consecutive paediatric patients undergoing allo-HSCT at our referral centre between January 2016 and July 2019 were evaluated. Post-transplant and nutritional outcomes of patients receiving EN for more than 7 days (EN group, n = 14) were compared with those of patients receiving EN for fewer than 7 days or receiving only PN (PN group, n = 28). In the EN group, a reduced incidence of Blood Stream Infections (BSI) was observed (p = 0.02) (n = 2 vs. n = 15; 14.3% vs. 53.6%). The type of nutritional support was also the only variable independently associated with BSI in the multivariate analysis (p = 0.03). Platelet engraftment was shorter in the PN group than in the EN group for a threshold of > 20*109/L (p = 0.04) (23.1 vs 35.7 days), but this correlation was not confirmed with a threshold of > 50*109/L. The Body Mass Index (BMI) and the BMI Z-score were no different in the two groups from admission to discharge.Our results highlight that EN is a feasible and nutritionally adequate method of nutritional support for children undergoing allo-HSCT in line with the present literature. Future functional studies are needed to better address the hypothesis that greater intestinal eubyosis maintained with EN may explain the observed reduction in BSI.
- Published
- 2020