Nutritional Advancement in the Hospitalized Child After NPO: A Retrospective Cohort Study.

Abstract

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.

• Authors: Alina G Burek, Tracey Liljestrom, Kelsey Porada, Lauren Matschull, Amy Pan, Peter L Havens, Praveen S Goday
• Journal: Hospital pediatrics (Hosp Pediatr) Vol. 10 Issue 1 Pg. 90-94 (01 2020) ISSN: 2154-1671 [Electronic] United States
• PMID: 31882443 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2020 by the American Academy of Pediatrics.

Topics

• Abdominal Pain
• Child
• Child, Hospitalized
• Diet
• Gastrointestinal Diseases (therapy)
• Hospitalization
• Humans
• Length of Stay
• Retrospective Studies