TY - JOUR
T1 - Nutritional support for children during critical illness
T2 - European Society of Pediatric and Neonatal Intensive Care (ESPNIC) metabolism, endocrine and nutrition section position statement and clinical recommendations
AU - Tume, Lyvonne N.
AU - Valla, Frederic V.
AU - Joosten, Koen
AU - Jotterand Chaparro, Corinne
AU - Latten, Lynne
AU - Marino, Luise V.
AU - Macleod, Isobel
AU - Moullet, Clémence
AU - Pathan, Nazima
AU - Rooze, Shancy
AU - van Rosmalen, Joost
AU - Verbruggen, Sascha C.A.T.
N1 - Funding Information:
We want to thank Elise Krabbendam, Sabrina Gunput, Gerdien de Jong and Wichor Bramer, Biomedical Information Specialists of the Medical Library of the Erasmus Medical Centre, Rotterdam, The Netherlands. The costs covering the open access publication of this article are covered by ESPNIC.
Funding Information:
The authors of these guidelines have reported all potential conflicts or financial disclosures. For a complete overview of the potential conflicts and financial disclosures see below. No funding or contribution from industry was involved in the completion of these recommendations, nor were any industry representatives present at any of the committee meetings. LNT is a member of the NIHR. SCV is supported by Nutricia Advanced Medical Nutrition (unrestricted research grant). SCV has received speakers’ fees from Nutricia Advanced Medical Nutrition and Baxter in the past. KJ is supported by Nutricia Advanced Medical Nutrition (unrestricted research grant). FVV has received speaker fees from Fresenius Kabi and Nutricia (past) and consultant fees from Baxter (current). LVM is supported by a Health Education England/NIHR Clinical Lectureship (ICA-CL-2016-02-001) supported by the National Institute for Health Research. LVM has also received speaker’s fees from Abbott Laboratories and Nutricia in the past. NP is supported by research funding from the National Institute for Health Research. CJC is supported by the Marisa Sophie Foundation and has received travel fees from Nutricia and Baxter (past). CM is supported by the Marisa Sophie Foundation and has received travel fees from Nutricia and Baxter (past).
Publisher Copyright:
© 2020, The Author(s).
PY - 2020/3/1
Y1 - 2020/3/1
N2 - Background: Nutritional support is considered essential for the outcome of paediatric critical illness. There is a lack of methodologically sound trials to provide evidence-based guidelines leading to diverse practices in PICUs worldwide. Acknowledging these limitations, we 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. Objective: To provide an ESPNIC position statement and make clinical recommendations for the assessment and nutritional support in critically ill infants and children. Design: The metabolism, endocrine and nutrition (MEN) section of the European Society of Pediatric and Neonatal Intensive Care (ESPNIC) generated 15 clinical questions regarding different aspects of nutrition in critically ill children. After a systematic literature search, the Scottish Intercollegiate Guidelines Network (SIGN) grading system was applied to assess the quality of the evidence, conducting meta-analyses where possible, to generate statements and clinical recommendations, which were then voted on electronically. Strong consensus (> 95% agreement) and consensus (> 75% agreement) on these statements and recommendations was measured through modified Delphi voting rounds. Results: The final 15 clinical questions generated a total of 7261 abstracts, of which 142 publications were identified relevant to develop 32 recommendations. A strong consensus was reached in 21 (66%) and consensus was reached in 11 (34%) of the recommendations. Only 11 meta-analyses could be performed on 5 questions. Conclusions: We present a position statement and clinical practice recommendations. The general level of evidence of the available literature was low. We have summarised this and provided a practical guidance for the paediatric critical care clinicians around important clinical questions.
AB - Background: Nutritional support is considered essential for the outcome of paediatric critical illness. There is a lack of methodologically sound trials to provide evidence-based guidelines leading to diverse practices in PICUs worldwide. Acknowledging these limitations, we 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. Objective: To provide an ESPNIC position statement and make clinical recommendations for the assessment and nutritional support in critically ill infants and children. Design: The metabolism, endocrine and nutrition (MEN) section of the European Society of Pediatric and Neonatal Intensive Care (ESPNIC) generated 15 clinical questions regarding different aspects of nutrition in critically ill children. After a systematic literature search, the Scottish Intercollegiate Guidelines Network (SIGN) grading system was applied to assess the quality of the evidence, conducting meta-analyses where possible, to generate statements and clinical recommendations, which were then voted on electronically. Strong consensus (> 95% agreement) and consensus (> 75% agreement) on these statements and recommendations was measured through modified Delphi voting rounds. Results: The final 15 clinical questions generated a total of 7261 abstracts, of which 142 publications were identified relevant to develop 32 recommendations. A strong consensus was reached in 21 (66%) and consensus was reached in 11 (34%) of the recommendations. Only 11 meta-analyses could be performed on 5 questions. Conclusions: We present a position statement and clinical practice recommendations. The general level of evidence of the available literature was low. We have summarised this and provided a practical guidance for the paediatric critical care clinicians around important clinical questions.
KW - Child
KW - Enteral nutrition
KW - Guidelines
KW - Intensive care
KW - Paediatric
KW - Parenteral nutrition
UR - http://www.scopus.com/inward/record.url?scp=85079769381&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85079769381&partnerID=8YFLogxK
UR - https://research.edgehill.ac.uk/en/publications/90c844e2-96eb-4651-a42e-5cd90bf95ee7
U2 - 10.1007/s00134-019-05922-5
DO - 10.1007/s00134-019-05922-5
M3 - Article (journal)
C2 - 32077997
AN - SCOPUS:85079769381
SN - 0342-4642
VL - 46
SP - 411
EP - 425
JO - Intensive Care Medicine
JF - Intensive Care Medicine
IS - 3
ER -