Double-blind, randomized trial of long-chain polyunsaturated fatty acid supplementation in formula fed to preterm infants.

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Государственное образовательное учреждение дополнительного профессионального образования казанская государственная медицинская академия министерство здравоохранения и социального развития российской федерации

Enteral glutamine supplementation for the very low birthweight infant : Plasma amino acid concentrations : Glutamine nutrition and metabolism : Bridging clinical medicine and basic science

Nutritional assessment and enteral support of critically ill children.

Background: Enteral feeding is challenging in critically ill infants. Target
intakes are often not achieved as a result of fluid restriction, procedural
interruptions and perceived enteral feeding intolerance. In those infants perceived to have poor feeding tolerance, the use of a peptide nutrient-energy
dense enteral feed (PEF) may improve nutritional intake and minimise feeding interruptions as a result of gastrointestinal symptoms. The aim of this
observational study was to characterise the use of a PEF amongst critically
ill infants in two paediatric intensive care units (PICUs).
Methods: Records from critically ill infants aged <12 months admitted to
two PICUs were retrospectively reviewed with a PICU length of stay
(LOS) ≥ 7 days. Achievement of nutritional targets for the duration of PEF
was reviewed. Gastrointestinal symptoms, including gastric residual volume,
constipation and vomiting, were evaluated as tolerance parameters.
Results: In total, 53 infants were included, with a median age on admission
of 2.6 months. Median admission weight was 3.9 kg in PICU-1 and 4.7 kg
in PICU-2. Median (interquatile range) energy intake in PICU-1 and PICU2 was 68 (47–92) and 90 (63–124) kcal kg1
, respectively, and median (interquatile range) protein intake 1.7 (1.1–2.4) g kg1 and 2.5 (1.6–3.2)
g kg1
, respectively. Feeding was withheld because of feeding intolerance in
one infant (4%) on two occasions in PICU-1 for 2.5 h and in two infants
(7%) on two occasions in PICU-2 for 19.5 h. Gastric residual mean (SD)
volumes were 3.5 (5.4) mL kg1 in PICU-1 and 16.9 (15.6) mL kg1 in
PICU-2.
Conclusions: Peptide nutrient-energy dense feeding in infants admitted to
the PICU is feasible, well tolerated and nutritional targets are met. However,
with this study design, it is not possible to draw any conclusions regarding
the benefit of PEF over standard PE feed in critically ill children and future
work is required to clarify this further.

Peptide nutrient-energy dense enteral feeding in critically ill infants: an observational study

textCritically ill children are at risk of deteriorating nutritional status when admitted to an intensive care unit. This may lead to malnutrition, which is associated with increased morbidity and mortality. While adequate feeding is essential for complete recovery and normal functional outcome of the growing child, caregivers on admission tend to focus on the primary medical problem. In order to provide good nutritional care it seems essential to fully assess the child’s nutritional status and needs. Various methods are available, and it is the child’s age, clinical presentation, and illness severity that determine which of them is most suitable as individual approach. This thesis describes the prevalence of malnutrition in critically ill children and investigates the applicability and usefulness of the available assessment methods for identifying children with poor initial nutritional status or at risk of developing malnutrition. We focused on the feasibility of routine use in the pediatric ICU setting. 
In this thesis we analyzed data obtained from a cohort of children receiving intensive care in the Erasmus MC-Sophia Children’s Hospital during the year 2001. This cohort consisted of preterm neonates, term neonates and older children aged 30 days-16 years.

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Jessie Hulst

Papers

Nutritional Assessment of Critically Ill Children: the search for practical tools