Journal ArticleDOI
Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Pediatric Critically Ill Patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition
Nilesh M. Mehta,Heather E. Skillman,Sharon Y. Irving,Jorge A. Coss-Bu,Sarah Vermilyea,Elizabeth Anne Farrington,Liam McKeever,Amber M. Hall,Praveen S. Goday,Carol L. Braunschweig +9 more
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TLDR
This document represents the first collaboration between two organizations, American Society of Parenteral and Enteral Nutrition and the Society of Critical Care Medicine, to describe best practices in nutrition therapy in critically ill children.Abstract:
This document represents the first collaboration between two organizations, American Society of Parenteral and Enteral Nutrition and the Society of Critical Care Medicine, to describe best practices in nutrition therapy in critically ill children. The target of these guidelines is intended to be the pediatric (> 1 mo and < 18 yr) critically ill patient expected to require a length of stay greater than 2 or 3 days in a PICU admitting medical, surgical, and cardiac patients. In total, 2,032 citations were scanned for relevance. The PubMed/Medline search resulted in 960 citations for clinical trials and 925 citations for cohort studies. The EMBASE search for clinical trials culled 1,661 citations. In total, the search for clinical trials yielded 1,107 citations, whereas the cohort search yielded 925. After careful review, 16 randomized controlled trials and 37 cohort studies appeared to answer one of the eight preidentified question groups for this guideline. We used the Grading of Recommendations, Assessment, Development and Evaluation criteria to adjust the evidence grade based on assessment of the quality of study design and execution. These guidelines are not intended for neonates or adult patients. The guidelines reiterate the importance of nutritional assessment, particularly the detection of malnourished patients who are most vulnerable and therefore potentially may benefit from timely intervention. There is a need for renewed focus on accurate estimation of energy needs and attention to optimizing protein intake. Indirect calorimetry, where feasible, and cautious use of estimating equations and increased surveillance for unintended caloric underfeeding and overfeeding are recommended. Optimal protein intake and its correlation with clinical outcomes are areas of great interest. The optimal route and timing of nutrient delivery is an area of intense debate and investigations. Enteral nutrition remains the preferred route for nutrient delivery. Several strategies to optimize enteral nutrition during critical illness have emerged. The role of supplemental parenteral nutrition has been highlighted, and a delayed approach appears to be beneficial. Immunonutrition cannot be currently recommended. Overall, the pediatric critical care population is heterogeneous, and a nuanced approach to individualizing nutrition support with the aim of improving clinical outcomes is necessary.read more
Citations
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Journal ArticleDOI
The prevalence and possible causes of enteral tube feeding intolerance in critically ill patients: A cross-sectional study
Farveh Yahyapoor,Zahra Dehnavi,Gholamreza Askari,Golnaz Ranjbar,Sudiyeh Hejri Zarifi,Mohammad Bagherniya,Majid Khadem Rezaian,Ahmad Bagheri Moghadaam,Farzane Fazeli,Alireza Sedaghat +9 more
TL;DR: Enteral tube feeding intolerance was prevalent in almost two-third (66%) of the critically ill patients receiving EN based on the GRV and was associated with deteriorated nutritional status and clinical outcomes.
Journal ArticleDOI
Management of Enteral Nutrition in the Pediatric Intensive Care Unit: Prokinetic Effects of Amoxicillin/Clavulanate in Real Life Conditions.
Fabrizio Chiusolo,Teresa Capriati,Ilaria Erba,Roberto Bianchi,Marta Ciofi Degli Atti,Sergio Picardo,Antonella Diamanti +6 more
TL;DR: The study aimed to assess the effectiveness and safety of amoxicillin/clavulanate (A/C) to treat EN intolerance and found the drug was well tolerated as shown by the similar safety outcomes in both cases and controls.
Journal ArticleDOI
Pilot Study to Investigate Enteral Feeding Practices and the Incidence of Underfeeding Among Mechanically Ventilated Critically Ill Patients at a Specialist Tertiary Care Hospital in Saudi Arabia.
Sara A Zaher,Raghad Al-Subaihi,Aeshah Al-Alshaya,Manar Al-Saggaf,Mariam O Al Amoudi,Hala Babtain,Arwa Neyaz +6 more
TL;DR: Protein-underfeeding remain a significant problem in ICU settings and it is crucial to implement effective feeding protocols to ensure early initiation of EN when permissible.
Journal ArticleDOI
Nutrition Is More Than the Sum of Its Parts.
TL;DR: It is important to continue to explore the relationship between outcome measures for children with TBI, and the researchers did not find an association between FSS at the time of admission to rehabilitation and the change in WeeFIM during rehabilitation, and it is uncertain if the conclusions reached are thoroughly proven.
Journal ArticleDOI
Comparison of the effect of three different protein content enteral diets on serum levels of proteins, nitrogen balance, and energy expenditure in critically ill infants: study protocol for a randomized controlled trial.
Reyes Fernández,Javier Urbano,Javier Urbano,Javier Urbano,Angel Carrillo,Angel Carrillo,Angel Carrillo,Ana Vivanco,Maria José Solana,Maria José Solana,Corsino Rey,Corsino Rey,Jesús López-Herce,Jesús López-Herce,Jesús López-Herce +14 more
TL;DR: Whether the administration of a protein-enriched infant formula increases the serum levels of total proteins, albumin, prealbumin, transferrin, and retinol and improves nitrogen balance and to analyze the effect of the high-protein diet on energy expenditure is examined.
References
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Journal ArticleDOI
Intensive Insulin Therapy in Critically Ill Patients
Greet Van den Berghe,Pieter Wouters,Frank Weekers,Charles Verwaest,Frans Bruyninckx,Miet Schetz,Dirk Vlasselaers,Patrick Ferdinande,Peter Lauwers,Roger Bouillon +9 more
TL;DR: Intensive insulin therapy to maintain blood glucose at or below 110 mg per deciliter reduces morbidity and mortality among critically ill patients in the surgical intensive care unit.
Journal ArticleDOI
Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.)
Nilesh M. Mehta,Heather E. Skillman,Sharon Y. Irving,Jorge A. Coss-Bu,Sarah Vermilyea,Elizabeth Anne Farrington,Liam McKeever,Amber M. Hall,Praveen S. Goday,Carol L. Braunschweig +9 more
TL;DR: The guidelines reiterate the importance of nutrition assessment-particularly, the detection of malnourished patients who are most vulnerable and therefore may benefit from timely intervention and there is a need for renewed focus on accurate estimation of energy needs and attention to optimizing protein intake.
Journal ArticleDOI
Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient
Stephen A. McClave,Robert G. Martindale,Vincent W. Vanek,Mary McCarthy,Pamela R. Roberts,Beth Taylor,Juan B. Ochoa,Lena Napolitano,Gail A. Cresci +8 more
Journal ArticleDOI
Intensive insulin therapy and mortality among critically ill patients: a meta-analysis including NICE-SUGAR study data
Donald E. G. Griesdale,Russell J. de Souza,Rob M. van Dam,Daren K. Heyland,Deborah J. Cook,Atul Malhotra,Rupinder Dhaliwal,William R. Henderson,Dean R. Chittock,Simon Finfer,Daniel Talmor +10 more
TL;DR: Intensive insulin therapy significantly increased the risk of hypoglycemia and conferred no overall mortality benefit among critically ill patients, but this therapy may be beneficial to patients admitted to a surgical ICU.