Objective: To examine the relationship between dose and exposure period of HM feeding and severity of illness in critically ill children with acute respiratory failure. The study seeks to determine if there are associations of dose and exposure period of HM feeding in critically ill children with respiratory failure and severity of illness on PICU admission; and among survivors, the duration of mechanical ventilation; and length of stay in the pediatric intensive care unit and hospital.
Methods: Subjects age 2 weeks to <37 months at enrollment in Randomized Evaluation of Sedation Titration fOr Respiratory Failure (RESTORE) (PI Curley, NCT00814099) trial who consented and enrolled in the follow up study Sedation Strategy and Cognitive Outcome After Critical Illness in Early Childhood (RESTORE-cog) (PI Curley & Watson, NCT02225041) were eligible for participation in this study. Each subject’s parent completed a feeding survey either by telephone or on mailed paper survey focused on dose and exposure period of HM feeding. All additional data was obtained from the RESTOREdatasets, including demographic data, etiology of respiratory failure and past medical history, severity of illness scores including oxygenation index and multisystem organ dysfunction, risk of mortality, length of mechanical ventilation duration, pediatric intensive care unit and hospital stay.
Measurement and Data analysis: To date, 158 children ages 2 weeks to <37 months have been enrolled in the study. Data analysis is underway and will include correlational analyses, simple and multiple regression and logistic regression to explore the relationship between dose and exposure period of HM feeding and severity of illness in critically ill children with respiratory failure. Propensity modeling will be used to statistically control for risk factors that may be associated with both human milk feeding and severity of illness in pediatric patients with acute respiratory failure.
Results: The results of the study will provide information on the impact of HM feeding on severe respiratory illness in critically ill children with acute respiratory failure that require mechanical ventilation – information that is currently not available. The results can help to inform clinical care practices as well as priority areas of research related to HM feeding and associations of dose and exposure for critically ill children with respiratory failure.
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