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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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
Systematic review of factors associated with energy expenditure in the critically ill.
Haifa Mtaweh,Maria Jose Soto Aguero,Marla Campbell,Johane P. Allard,Paul B. Pencharz,Eleanor Pullenayegum,Christopher S. Parshuram +6 more
TL;DR: An important interval step in the development of accurate formulae for energy expenditure estimation is a better understanding of relationships between patient and clinical factors and energy expenditure.
Journal ArticleDOI
Time to achieve delivery of nutrition targets is associated with clinical outcomes in critically ill children.
TL;DR: In this article, the authors examined the association between the time to achieve delivery of 60% of the prescribed energy and protein targets and clinical outcomes in mechanically ventilated children, and found that achieving 60% energy or protein delivery targets within the first 7 d after admission to the hospital was associated with lower 60-d mortality in critically ill children and not associated with a greater incidence of infections or a reduction in VFDs compared to later achievement of targets.
Journal ArticleDOI
Nutritional status and feeding practices in gastrointestinal surgery patients at Bach Mai Hospital, Hanoi, Vietnam.
Lorraine S. Young,Pham Thi Thu Huong,Nguyen Thi Lam,Nghiem Nguyet Thu,Ha Thi Van,Nguyen Lien Hanh,Le Danh Tuyen,Dinh Thi Kim Lien,Tran Hieu Hoc,Chu Thi Tuyet,Nguyen Quoc Anh,Elizabeth G. Henry,Carine M. Lenders,Kathleen M. Gura,Sherman J Bigornia,Caroline M. Apovian,Thomas R. Ziegler +16 more
TL;DR: Hospital malnutrition in surgical patients in Vietnam is a significant problem, peri-operative feeding appears suboptimal and use of early postoperative PN was routine.
Journal ArticleDOI
Gastrointestinal manifestations and nutritional therapy during COVID-19 pandemic: a practical guide for pediatricians.
TL;DR: Children and adolescents with gastrointestinal symptoms, such as nausea, vomiting and diarrhea, should be seriously suspected of COVID-19, and nutritional support plays an important role in treatment of pediatric patients, particularly those with severe or critical forms of the disease.
Journal ArticleDOI
Bolus vs Continuous Nasogastric Feeds in Mechanically Ventilated Pediatric Patients: A Pilot Study.
TL;DR: B-GF was associated with superior delivery of EN with a comparable safety profile to C-GF, and further study is needed to compare both EN methods in other PICU populations.
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.