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Intensive Care Medicine
Published in: Intensive Care Medicine 3/2020

Open Access 01-03-2020 | Nutrition | Expert Statement

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

Authors: Lyvonne N. Tume, Frederic V. Valla, Koen Joosten, Corinne Jotterand Chaparro, Lynne Latten, Luise V. Marino, Isobel Macleod, Clémence Moullet, Nazima Pathan, Shancy Rooze, Joost van Rosmalen, Sascha C. A. T. Verbruggen

Published in: Intensive Care Medicine | Issue 3/2020

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Abstract

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.
Appendix
Available only for authorised users
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Metadata
Title
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
Authors
Lyvonne N. Tume
Frederic V. Valla
Koen Joosten
Corinne Jotterand Chaparro
Lynne Latten
Luise V. Marino
Isobel Macleod
Clémence Moullet
Nazima Pathan
Shancy Rooze
Joost van Rosmalen
Sascha C. A. T. Verbruggen
Publication date
01-03-2020
Publisher
Springer Berlin Heidelberg
Keywords
Nutrition
Care
Published in
Intensive Care Medicine / Issue 3/2020
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-019-05922-5

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