Abstract:

Objective To investigate incidence of enteral nutrition feeding intolerance（FI） in pediatric patients receiving non-invasive ventilation in the neonatal intensive care unit（NICU） and analyze influencing factors for FI，for providing reference for preventing FI. Methods 172 pediatric patients receiving non-invasive ventilation in NICU in a class A tertiary hospital in Urumqi from January 2022 to March 2024 were collected as research subjects. Clinical data of the research subjects were investigated through medical record system and their clinical data were retrospectively analyzed. Incidence of FI was observed. Those pediatric patients were divided into FI group and non-FI group based on whether FI occurred and clinical data were compared between the two groups. Logistic regression was used to analyze influencing factors of FI. Receiver operating curve（ROC） was drawn to evaluate prediction value of Logistic regression model for FI. Results Among 172 pediatric patients，37.2% experienced FI. The proportion of premature infants，proportion of neonatal respiratory distress syndrome（NRDS），Acute Physiological and Chronic Health Ⅱ（APACHE Ⅱ） score，time to first enteral nutrition，nasal intermittent positive pressure ventilation，intra-abdominal pressure and proportion of use of sedatives in the FI group were higher than those in the non-FI group（P<0.05）. Logistic regression showed that premature infants（OR=5.516），NRDS（OR=4.242），APACHE Ⅱ score（OR=1.797），time to first enteral nutrition（OR=1.163），nasal intermittent positive pressure ventilation（OR=4.029），intra-abdominal pressure（OR=2.017） and use of sedatives（OR=4.247） were all independent risk factors for FI in NICU patients receiving non-invasive ventilation（P<0.05）. ROC analysis showed that the area under the curve（AUC） of the Logistic regression model was 0.974，with a sensitivity of 96.9% and a specificity of 91.7%，indicating good predictive performance. Conclusion Pediatric patients receiving non-invasive ventilation in NICU have a high incidence of enteral nutrition FI. Premature infants，NRDS，APACHE Ⅱ score，first enteral nutrition，nasal intermittent positive pressure ventilation，intra-abdominal pressure and use of sedatives are risk factors for FI. For pediatric patients with the above-mentioned FI risk factors，they should be intervened early. And we should start enteral nutrition support as early as possible，choose an appropriate ventilation mode and try to avoid and reduce the use of sedatives.

Key words: Neonatal Intensive Care Unit, Non-Invasive Ventilator Ventilation, Enteral Nutrition, Feeding Intolerance, Risk Factors, Critical Care Nursing