Enteral versus Parenteral Nutrition in Pediatric Hematopoietic Stem Cell Transplant Patients: An Integrative Review of Literature

Theresa Woods, DePaul University
Joseph Tariman, PhD, DePaul University

Description

Enteral versus Parenteral Nutrition in Pediatric Hematopoietic Stem Cell Transplant Patients: An Integrative Review of Literature

Theresa Woods

Faculty Sponsor: Dr. Joseph Tariman

Background: Multiple factors attribute to an impaired nutritional status in post- hematopoietic stem cell transplant (HSCT) patients and additional elements influence pediatric nutrition. Forms of supplemental nutrition include enteral nutrition (EN) and parenteral nutrition (PN) but there is minimal research in the pediatric post-HSCT population and a contradiction between practice and research is evident.

Objectives: To determine if EN or PN is recommended for meeting nutritional and energy requirements of pediatric patients after a hematopoietic stem cell transplant

Method: This integrative literature review used articles published from 2005-2018 using PubMed, CINAHL, ProQuest, Cochrane Library and Ovid Medline. The keywords were pediatric, child, preschool, infant, adolescent, hematopoietic stem cell transplant, nutrition, parenteral nutrition, enteral nutrition and tube feeding. Statistical findings were evaluated based on their evidence of meeting nutrition and energy requirements.

Results: 7 articles were found. 30 statistical findings were pulled from the articles. 16 findings were associated to EN and 81.3% (n=13) were positively associated to EN. 5 findings were found for EN-PN nutrition and 20% (n=1) was positively associated to maintaining nutrition. 9 statistical findings were reported on for PN and 33.3% (n=3) were found to have positive associations for maintaining nutrition.

Conclusion: Based on EN’s ability to maintain an acceptable BMI, limit occurrence of complications, preserve F/E balances, decrease LOS, increase SR 100 days post-HSCT and maintain or increase weight, this integrative literature review appears to support the use of EN for nutritional support in post-HSCT pediatric patients. More research is needed in order to establish a standard of care and, in the meantime, nurses need to educate their patients and colleagues on the benefits of EN.

 
Aug 17th, 10:00 AM Aug 17th, 11:30 AM

Enteral versus Parenteral Nutrition in Pediatric Hematopoietic Stem Cell Transplant Patients: An Integrative Review of Literature

Enteral versus Parenteral Nutrition in Pediatric Hematopoietic Stem Cell Transplant Patients: An Integrative Review of Literature

Theresa Woods

Faculty Sponsor: Dr. Joseph Tariman

Background: Multiple factors attribute to an impaired nutritional status in post- hematopoietic stem cell transplant (HSCT) patients and additional elements influence pediatric nutrition. Forms of supplemental nutrition include enteral nutrition (EN) and parenteral nutrition (PN) but there is minimal research in the pediatric post-HSCT population and a contradiction between practice and research is evident.

Objectives: To determine if EN or PN is recommended for meeting nutritional and energy requirements of pediatric patients after a hematopoietic stem cell transplant

Method: This integrative literature review used articles published from 2005-2018 using PubMed, CINAHL, ProQuest, Cochrane Library and Ovid Medline. The keywords were pediatric, child, preschool, infant, adolescent, hematopoietic stem cell transplant, nutrition, parenteral nutrition, enteral nutrition and tube feeding. Statistical findings were evaluated based on their evidence of meeting nutrition and energy requirements.

Results: 7 articles were found. 30 statistical findings were pulled from the articles. 16 findings were associated to EN and 81.3% (n=13) were positively associated to EN. 5 findings were found for EN-PN nutrition and 20% (n=1) was positively associated to maintaining nutrition. 9 statistical findings were reported on for PN and 33.3% (n=3) were found to have positive associations for maintaining nutrition.

Conclusion: Based on EN’s ability to maintain an acceptable BMI, limit occurrence of complications, preserve F/E balances, decrease LOS, increase SR 100 days post-HSCT and maintain or increase weight, this integrative literature review appears to support the use of EN for nutritional support in post-HSCT pediatric patients. More research is needed in order to establish a standard of care and, in the meantime, nurses need to educate their patients and colleagues on the benefits of EN.