Background/Objectives: Iron deficiency anemia is common in the pediatric population. Red blood cell transfusions, a common acute treatment, pose well-recognized risks including lung injury, circulatory overload, and immune dysfunction. Intravenous iron, specifically sodium ferric gluconate complex (SFGC), is a potential alternative, however investigation on its use in hospitalized children is lacking. This study aims to describe the physiologic response via change in hematologic values to cumulative dose of SFGC, investigate the effect of cumulative dosing on the amount of RBC transfusions received, and comment on its safety. Methods: This is a retrospective investigation of pediatric patients with iron deficiency who received SFGC during their admission to the Helen DeVos Children’s Hospital between 2016 and 2018 (N = 85). Results: A total of 258 doses of intravenous SFGC were provided to 85 patients. The average pre-treatment serum hemoglobin was 8.73 ± 1.33, and 7 days post-treatment this increased to 10.41 ± 1.43. Mean corpuscular volume, ferritin, serum ion, total iron binding capacity, reticulocyte percentage, and reticulocyte hemoglobin all increased 7 days post-treatment, as would be suspected, but without any statistically significant difference between hematologic outcomes and cumulative dose of SFGC. Our study did not reveal any correlation between the cumulative dose of SFGC administered and the amount of RBC transfusions received. Only one adverse event was recorded. Conclusions: Our results complement the trend of increased use and emerging evidence of favorable safety profiles of IV iron in the pediatric population. This descriptive investigation revealed that administering higher cumulative doses of SFGC provided no further benefits in terms of hematologic response or RBC transfusion administration.

Background/Objectives: Survival after pediatric intensive care unit (PICU) admission has improved, yet many children experience post-intensive care syndrome in pediatrics (PICS-p), including persistent feeding difficulties that impair growth and quality of life. An intensive feeding program (IFP), also known as intensive interdisciplinary behavioral treatment (IIBT), reduces tube dependence and improves oral intake; however, outcomes in PICU survivors remain understudied. This study aimed to evaluate feeding outcomes in children with prior PICU admission who completed IIBT. Methods: This study was a retrospective case series of children (0–18 years) admitted to the HDVCH, Corewell Health, Grand Rapids, Michigan, who subsequently completed IIBT (from 2007 to 2024). Variables included demographics, PICU course (admission indication, complications, length of stay, ventilation, and nutrition status) and IIBT outcomes (feeding modality, oral skills, and malnutrition status). Feeding outcomes were compared pre- and post-IIBT. Results: Sixteen patients were included (62.5% female; mean age 1.44 ± 1.21 years). Primary PICU admission causes were post-operative recovery (68.8%) and acute respiratory failure (25%). PICU complications included acute respiratory failure (43.8%) and the need for respiratory support beyond baseline (62.5%). At PICU discharge, 75% remained tube-fed and 18.8% were malnourished. The mean time from PICU discharge to IIBT initiation was 641 ± 385 days. At IIBT baseline, 75% were tube-fed and all were non-self-feeders. Following IIBT completion (mean length of stay 4.8 ± 0.9 weeks), 58% of tube-fed patients achieved tube removal eligibility; 44% transitioned to partial or full self-feeding; problematic mealtime behaviors decreased (45.7% → 9.9%); oral acceptance improved (62% → 95%); and mouth clearance improved (59% → 96%). Malnutrition prevalence decreased (20% → 12%). Conclusions: Children with prior PICU admission demonstrated substantial feeding and behavioral improvement during IIBT participation, with over half achieving tube-weaning eligibility. The time from referral to program start reflects barriers that delay intervention.