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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

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 av...

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Autores principales: Tume, Lyvonne N., Valla, Frederic V., Joosten, Koen, Jotterand Chaparro, Corinne, Latten, Lynne, Marino, Luise V., Macleod, Isobel, Moullet, Clémence, Pathan, Nazima, Rooze, Shancy, van Rosmalen, Joost, Verbruggen, Sascha C. A. T.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7067708/
https://www.ncbi.nlm.nih.gov/pubmed/32077997
http://dx.doi.org/10.1007/s00134-019-05922-5
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author Tume, Lyvonne N.
Valla, Frederic V.
Joosten, Koen
Jotterand Chaparro, Corinne
Latten, Lynne
Marino, Luise V.
Macleod, Isobel
Moullet, Clémence
Pathan, Nazima
Rooze, Shancy
van Rosmalen, Joost
Verbruggen, Sascha C. A. T.
author_facet Tume, Lyvonne N.
Valla, Frederic V.
Joosten, Koen
Jotterand Chaparro, Corinne
Latten, Lynne
Marino, Luise V.
Macleod, Isobel
Moullet, Clémence
Pathan, Nazima
Rooze, Shancy
van Rosmalen, Joost
Verbruggen, Sascha C. A. T.
author_sort Tume, Lyvonne N.
collection PubMed
description 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00134-019-05922-5) contains supplementary material, which is available to authorized users.
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spelling pubmed-70677082020-03-23 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. Valla, Frederic V. Joosten, Koen Jotterand Chaparro, Corinne Latten, Lynne Marino, Luise V. Macleod, Isobel Moullet, Clémence Pathan, Nazima Rooze, Shancy van Rosmalen, Joost Verbruggen, Sascha C. A. T. Intensive Care Med Expert Statement 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00134-019-05922-5) contains supplementary material, which is available to authorized users. Springer Berlin Heidelberg 2020-02-20 2020 /pmc/articles/PMC7067708/ /pubmed/32077997 http://dx.doi.org/10.1007/s00134-019-05922-5 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Expert Statement
Tume, Lyvonne N.
Valla, Frederic V.
Joosten, Koen
Jotterand Chaparro, Corinne
Latten, Lynne
Marino, Luise V.
Macleod, Isobel
Moullet, Clémence
Pathan, Nazima
Rooze, Shancy
van Rosmalen, Joost
Verbruggen, Sascha C. A. T.
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
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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
topic Expert Statement
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7067708/
https://www.ncbi.nlm.nih.gov/pubmed/32077997
http://dx.doi.org/10.1007/s00134-019-05922-5
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