Metabolic Stabilization & Weight Recovery with Peptamen Junior^® HP in Pediatric Patients with Traumatic Brain Injury (TBI)

Introduction

Nutritional support is critical in the management of critically ill children, particularly those at high risk of malnutrition due to hypermetabolic and catabolic states.^1,2 Traumatically injured children often face profound metabolic disturbances and increased energy needs that are difficult to meet early in the hospitalization. In the Pediatric Intensive Care Unit (PICU), early enteral nutrition has been associated with improved clinical outcomes and enhanced recovery.³

Background

A 9-year-old boy was admitted to the PICU with multiple injuries, including a severe traumatic brain injury. Enteral nutrition (EN) was started 60 hours post-admission with a high-protein, peptide-based formula (Peptamen Junior® HP). His course included 15 days of mechanical ventilation, tracheostomy and gastrostomy tube placement on day 11, and surgical repair of other injuries. PICU length of stay (LOS) was 18 days; total hospital LOS was 46 days.

Results

Metabolic Stabilization

Measured resting energy expenditure (MREE) via indirect calorimetry:

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Optimal respiratory quotient (RQ):

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The RQ remained stable at 0.86 in both studies, indicating a mixed substrate utilization and an optimal metabolic state.

Weight Recovery

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Patient weight at admission was 48 kg. Weight dropped to 43.5 kg during the acute phase before recovering to 46 kg at PICU discharge.

Clinical Improvement

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Laboratory markers supported the presence of hypermetabolism and catabolic stress, with improvement in nitrogen balance and metabolic stability over the course of the PICU stay.