Обзорная статья

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. TumeFaculty of Health and Society, University of Salford, Manchester, M6 6PU, UK. [email protected]Frédéric V. VallaPediatric Intensive Care Unit, Hôpital Femme Mère Enfant, CarMEN INSERM UMR, 1060 Hospices Civils de Lyon, Lyon-Bron, FranceKoen F. M. JoostenIntensive Care, Department of Pediatrics and Pediatric Surgery, Erasmus Medical Centre, Sophia Children's Hospital, Rotterdam, The NetherlandsCorinne Jotterand ChaparroGeneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Delémont, SwitzerlandLynne LattenNutrition and Dietetics, Alder Hey Children's Hospital Liverpool, Liverpool, UKLuise V. MarinoDepartment of Dietetics/Speech and Language Therapy, NIHR Biomedical Research Centre Southampton, University Hospital Southampton, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UKI. MacleodPediatric Intensive Care Unit, Royal Hospital for Children, Glasgow, UKClémence MoulletGeneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Delémont, SwitzerlandNazima PathanDepartment of Pediatrics, University of Cambridge, Hills Road, Cambridge, UKShancy RoozePediatric Intensive Care Unit, Queen Fabiola Children's University Hospital, Brussels, BelgiumJoost van RosmalenDepartment of Biostatistics, Erasmus Medical Centre Rotterdam, Rotterdam, The NetherlandsSascha VerbruggenIntensive Care, Department of Pediatrics and Pediatric Surgery, Erasmus Medical Centre, Sophia Children's Hospital, Rotterdam, The Netherlands

2020en

ABI

Аннотация

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.

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Идентификаторы

DOI: 10.1007/s00134-019-05922-5

Цитирования и источники

Цитирований: 2Использованных источников: 0

Показатели — AkademScholar