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
Reads0
Chats0
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
More filters
Journal ArticleDOI
Nutritional support for children during critical illness: European Society of Pediatric and Neonatal Intensive Care (ESPNIC) metabolism, endocrine and nutrition section position statement and clinical recommendations
Lyvonne N Tume,Frédéric V. Valla,Koen F.M. Joosten,Corinne Jotterand Chaparro,Corinne Jotterand Chaparro,Lynne Latten,Luise V. Marino,Isobel Macleod,C. Moullet,C. Moullet,Nazima Pathan,Shancy Rooze,Joost van Rosmalen,Sascha Verbruggen +13 more
TL;DR: This work aimed to summarize the available literature and provide practical guidance for the paediatric critical care clinicians around important clinical questions many of which are not covered by previous guidelines.
Journal ArticleDOI
Shiga Toxin-Associated Hemolytic Uremic Syndrome: A Narrative Review.
TL;DR: This work reviews the current knowledge of STEC virulence, how societies organize the prevention of human disease, and how physicians treat its potentially fatal complications, and focuses on STEC-induced hemolytic and uremic syndrome.
Journal ArticleDOI
Indirect Calorimetry: History, Technology, and Application.
TL;DR: The historical development, technical, and logistic challenges of indirect calorimetry measurement are reviewed, case examples for practicing clinicians are provided, and formulae to estimate energy expenditure are highly inaccurate.
Journal ArticleDOI
The Role of Nutrition for Pressure Injury Prevention and Healing: The 2019 International Clinical Practice Guideline Recommendations.
Nancy Munoz,Nancy Munoz,Mary Ellen Posthauer,Emanuele Cereda,Jos M. G. A. Schols,Emily Haesler +5 more
TL;DR: The purpose of this manuscript is to review the nutrition-related recommendations presented in the 2019 European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory panel, and Pan Pacific Pressure Injury Alliance Prevention and Treatment of Pressure Ulcers/Injuries: Clinical Practice Guideline with further discussion of nutrition for pressure injury management in the context of the recommendations.
Journal ArticleDOI
Enteral Feeding Practices in Infants With Congenital Heart Disease Across European PICUs: A European Society of Pediatric and Neonatal Intensive Care Survey.
Lyvonne N Tume,Reinis Balmaks,Eduardo da Cruz,Lynne Latten,Sascha Verbruggen,Frédéric V. Valla +5 more
TL;DR: Wide variations in practices exist in the nutritional care between European PICUs, which reflects the absence of local protocols and scientific society-endorsed guidelines, and is likely to contribute to suboptimal energy delivery in this particularly vulnerable group of infants.
References
More filters
Journal ArticleDOI
Malnutrition risk in hospitalized children: use of 3 screening tools in a large European population
Michael Chourdakis,Christina Hecht,Konstantinos Gerasimidis,Koen F.M. Joosten,Thomais Karagiozoglou-Lampoudi,Harma A. Koetse,Janusz Ksiazyk,Cecilia Lazea,Raanan Shamir,Hania Szajewska,Berthold Koletzko,Jessie M. Hulst +11 more
TL;DR: The identification and classification of malnutrition risk varied across the pediatric tools used, and the data obtained do not allow recommending the use of any of these screening tools for clinical practice.
Journal ArticleDOI
Hospital malnutrition and inflammatory response in critically ill children and adolescents admitted to a tertiary intensive care unit.
Artur Figueiredo Delgado,Thelma Suely Okay,Claudio Leone,Buford L. Nichols,Gilda Maria Barbaro Del Negro,Flávio Adolfo Costa Vaz +5 more
TL;DR: Malnourished patients maintain the capacity to release inflammatory markers such as CRP and IL-6, which can be considered favorable for combating infections On the other hand, this capacity might also have a significant impact on nutritional status during hospitalization.
Journal ArticleDOI
Cumulative energy imbalance in the pediatric intensive care unit: role of targeted indirect calorimetry.
TL;DR: Targeted indirect calorimetry on high-risk patients selected by a dedicated nutrition team may prevent cumulative excesses and deficits in energy balance.
Journal ArticleDOI
Systematic Review of the Influence of Energy and Protein Intake on Protein Balance in Critically Ill Children
TL;DR: There is a correlation between higher energy and protein intakes and achievement of positive protein balance in children receiving mechanical ventilation in the pediatric intensive care unit, and a variety of protocols have been used to determine nitrogen balance.
Journal ArticleDOI
Effectiveness and safety of a protocol for promotion of early intragastric feeding in critically ill children.
TL;DR: This study showed that increases of caloric intake during the acute phase of a critical illness are well tolerated and may approach PBMR by the second day and PEE by the fourth day in critically ill children.