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Early versus Late Parenteral Nutrition in Critically Ill Children.

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TLDR
In critically ill children, withholding parenteral nutrition for 1 week in the ICU was clinically superior to providing early parenTERal nutrition.
Abstract
BackgroundRecent trials have questioned the benefit of early parenteral nutrition in adults. The effect of early parenteral nutrition on clinical outcomes in critically ill children is unclear. MethodsWe conducted a multicenter, randomized, controlled trial involving 1440 critically ill children to investigate whether withholding parenteral nutrition for 1 week (i.e., providing late parenteral nutrition) in the pediatric intensive care unit (ICU) is clinically superior to providing early parenteral nutrition. Fluid loading was similar in the two groups. The two primary end points were new infection acquired during the ICU stay and the adjusted duration of ICU dependency, as assessed by the number of days in the ICU and as time to discharge alive from ICU. For the 723 patients receiving early parenteral nutrition, parenteral nutrition was initiated within 24 hours after ICU admission, whereas for the 717 patients receiving late parenteral nutrition, parenteral nutrition was not provided until the morning o...

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Citations
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Journal ArticleDOI

Surviving Sepsis Campaign International Guidelines for the Management of Septic Shock and Sepsis-Associated Organ Dysfunction in Children

Scott L. Weiss, +53 more
TL;DR: A large cohort of international experts was able to achieve consensus regarding many recommendations for the best care of children with sepsis, acknowledging that most aspects of care had relatively low quality of evidence resulting in the frequent issuance of weak recommendations.
Journal ArticleDOI

Hypoalbuminemia: Pathogenesis and Clinical Significance.

TL;DR: Management of hypoalbuminaemia should be based on correcting the causes of ongoing inflammation rather than infusion of albumin, and increasing or decreasing serum albumin levels are adequate indicators, respectively, of improvement or deterioration of the clinical state.
Journal ArticleDOI

Surviving sepsis campaign international guidelines for the management of septic shock and sepsis-associated organ dysfunction in children

Scott L. Weiss, +54 more
TL;DR: A large cohort of international experts was able to achieve consensus regarding many recommendations for the best care of children with sepsis, acknowledging that most aspects of care had relatively low quality of evidence resulting in the frequent issuance of weak recommendations.
Journal ArticleDOI

Neonatal Acute Kidney Injury.

TL;DR: This review highlights the deficits in the understanding of neonatal AKI that require further investigation and discusses the need for long-term follow-up of neonates with AKI to identify those children who will go on to develop chronic kidney disease.
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ICU-acquired weakness

TL;DR: Results of studies investigating the impact of early mobilization, neuromuscular electrical stimulation and of pharmacological interventions were inconsistent, with recent systematic reviews/meta-analyses revealing no or only low-quality evidence for benefit.
References
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Journal ArticleDOI

Autophagy in immunity and inflammation

TL;DR: A crucial role is revealed for the autophagy pathway and proteins in immunity and inflammation, and they balance the beneficial and detrimental effects of immunity andinflammation, and thereby may protect against infectious, autoimmune and inflammatory diseases.
Journal ArticleDOI

1. Guidelines on Paediatric Parenteral Nutrition of the European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and the European Society for Clinical Nutrition and Metabolism (ESPEN), Supported by the European Society of Paediatric Research (ESPR).

TL;DR: These Guidelines for Paediatric Parenteral Nutrition have been developed as a mutual project of the European Society for paediatric Gastroenterology, Hepatology and Nutrition and the European society for Clinical Nutrition and Metabolism.
Journal ArticleDOI

Autophagy Is Required to Maintain Muscle Mass

TL;DR: It is reported that muscle-specific deletion of a crucial autophagy gene, Atg7, resulted in profound muscle atrophy and age-dependent decrease in force and the results suggest that inhibition/alteration of Autophagy can contribute to myofiber degeneration and weakness in muscle disorders characterized by accumulation of abnormal mitochondria and inclusions.
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