Peptide-based versus standard polymeric enteral nutrition in the PICU: a multicenter observational study
Frontiers in Nutrition, cilt.13, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 13
- Basım Tarihi: 2026
- Doi Numarası: 10.3389/fnut.2026.1824914
- Dergi Adı: Frontiers in Nutrition
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Directory of Open Access Journals
- Anahtar Kelimeler: enteral nutrition, pediatric intensive care unit, peptide-based formula, standard polymeric formula, undernutrition
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Eskişehir Osmangazi Üniversitesi Adresli: Evet
Özet
Background – Nutritional guidelines recommend initiating enteral nutrition with standard polymeric formula (SPF) in critically ill children. Peptide-based formulas (PBF) have been increasingly used to improve enteral nutrition and reduce related complications. This study evaluated the clinical outcomes associated with PBF use compared with SPF in the PICU setting. Methods – This multicenter, prospective study included pediatric patients admitted to PICUs who received enteral nutrition. Patients receiving PBFs were compared with those receiving SPFs. To reduce baseline imbalances and potential confounding, propensity score matching with inverse probability of treatment weighting (IPTW) was applied. Results – A total of 574 patients were included. After IPTW adjustment, baseline characteristics were well balanced between groups. The rate of achieving target caloric intake by day 2 was significantly higher in the SPF group (p < 0.001); whereas no significant difference was observed by day 7 (mean difference = 0.7, p = 0.853). After adjustment, the incidence of nosocomial infections was significantly higher in the SPF group compared with the PBF group [23.5 vs. 17.6%; OR = 0.7 (95% CI, 0.5–0.9); p = 0.015]. Significantly greater reduction in proteins consumed on day 2 was observed in favor of the SPF group (mean difference −0.3, p < 0.001). Constipation was significantly more common in the SPF group (p = 0.010). Conclusions – Although early caloric and protein intake was higher in patients receiving standard polymeric formulas, outcomes were comparable by day 7. Lower infection rates and reduced need for mechanical ventilation were observed in patients receiving peptide-based formulas. Enteral formula selection should be individualized, and further studies are needed to clarify this subject.