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
Biomarkers in critical care nutrition
Christian Stoppe,Sebastian Wendt,Nilesh M. Mehta,Charlene Compher,Jean-Charles Preiser,Daren K. Heyland,Daren K. Heyland,Arnold S. Kristof +7 more
TL;DR: The need for practical risk stratification tools in critical care nutrition, a proposed rationale for targeted biomarker development, and potential approaches that can be adopted for biomarker identification and validation in the field are discussed.
Journal ArticleDOI
High-energy nutrition in paediatric cardiac critical care patients: a randomized controlled trial
TL;DR: Infants after cardiac surgery fed with HF gained more weight but had increased feeding intolerance, however, the feeding intolerance symptoms could be relieved by medication and did not affect feeding advancement.
Journal ArticleDOI
Estimation of Resting Energy Expenditure Using Predictive Equations in Critically Ill Children: Results of a Systematic Review.
Corinne Jotterand Chaparro,Corinne Jotterand Chaparro,C. Moullet,Patrick Taffé,J. Depeyre,Marie-Hélène Perez,David Longchamp,Jacques Cotting +7 more
TL;DR: It is concluded that a new validated indirect calorimeter is urgently needed in the critically ill pediatric population because the Schofield equations and Talbot tables were the least inaccurate of the predictive equations.
Journal ArticleDOI
Nutrition Considerations in the Pediatric Cardiac Intensive Care Unit Patient.
Lindsey Justice,Jason R. Buckley,Alejandro A. Floh,Megan Horsley,Jeffrey A. Alten,Vijay Anand,Vijay Anand,Steven M. Schwartz +7 more
TL;DR: The Pediatric Cardiac Intensive Care Society sought to provide an expert review on provision of nutrition to pediatric cardiac intensive care patients, including caloric requirements, practical considerations for providing nutrition, safety of enteral nutrition in controversial populations, feeding considerations with chylothorax, and the benefits of feeding beyond nutrition.
Journal ArticleDOI
Nutritional support in the recovery phase of critically ill children
TL;DR: During the recovery phase of paediatric critical illness (catch-up) growth and muscle recovery, nutritional intakes require nutritional intakes at least two times the resting energy expenditure.
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.