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

Tume, Lyvonne N. (Faculty of Health and Society, University of Solford ; Pediatric Intensive Care Unit, Liverpool) ; Valla, Frédéric V. (Pediatric Intensive Care Unit, Hôpital Femme Mère Enfant) ; Joosten, Koen (Intensive Care, Sophia Children’s Hospital, Rotterdam) ; Jotterand Chaparro, Corinne (Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland ; Pediatric Intensive Care Unit, University Hospital of Lausanne, Lausanne, Switzerland) ; Latten, Lynne (Nutrition and Dietetics, Liverpool) ; Marino, Luise V. (Department of Dietetics/Speech and Language Therapy, Southampton, UK) ; Macleod, Isobel (Pediatric Intensive Care Unit, Glasgow) ; Moullet, Clémence (Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland ; Pediatric Intensive Care Unit, University Hospital of Lausanne, Lausanne, Switzerland) ; Pathan, Nazima (Department of Pediatrics, University of Cambridge) ; Rooze, Shancy (Pediatric Intensive Care Unit, Queen Fabiola Children’s University Hospital, Brussels) ; Van Rosmalen, Joost (Erasmus Medical Centre Rotterdam, Rotterdam) ; Verbruggen, Sascha C. A. T. (Intensive Care, Sophia Children’s Hospital, Rotterdam)

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.


Keywords:
Article Type:
scientifique
Faculty:
Santé
School:
HEdS - Genève
Institute:
Aucun institut
Date:
2020-02
Pagination:
15 p.
Published in:
Intensive Care Medicine
Numeration (vol. no.):
2020, vol. 46, pp. 411-425
DOI:
ISSN:
0342-4642
Appears in Collection:



 Record created 2020-10-27, last modified 2021-02-01

Fulltext:
Download fulltext
PDF

Rate this document:

Rate this document:
1
2
3
 
(Not yet reviewed)