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Jacobs A, Verlinden I, Vanhorebeek I, et al. Early Supplemental Parenteral Nutrition in Critically Ill Children: An Update. J Clin Med. 2019;8(6)doi: 10.3390/jcm8060830.
Jacobs, A., Verlinden, I., Vanhorebeek, I., & Van den Berghe, G. (2019). Early Supplemental Parenteral Nutrition in Critically Ill Children: An Update. Journal of clinical medicine, 8(6), . https://doi.org/10.3390/jcm8060830
Jacobs, An, et al. "Early Supplemental Parenteral Nutrition in Critically Ill Children: An Update." Journal of clinical medicine vol. 8,6 (2019). doi: https://doi.org/10.3390/jcm8060830
Jacobs A, Verlinden I, Vanhorebeek I, Van den Berghe G. Early Supplemental Parenteral Nutrition in Critically Ill Children: An Update. J Clin Med. 2019 Jun 11;8(6). doi: 10.3390/jcm8060830. PMID: 31212639; PMCID: PMC6616588.
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J Clin Med. 2019 Jun 11;8(6). doi: 10.3390/jcm8060830.

Early Supplemental Parenteral Nutrition in Critically Ill Children: An Update.

Journal of clinical medicine

An Jacobs, Ines Verlinden, Ilse Vanhorebeek, Greet Van den Berghe

Affiliations

  1. Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven University Hospital, 3000 Leuven, Belgium. [email protected].
  2. Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven University Hospital, 3000 Leuven, Belgium. [email protected].
  3. Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven University Hospital, 3000 Leuven, Belgium. [email protected].
  4. Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven University Hospital, 3000 Leuven, Belgium. [email protected].

PMID: 31212639 PMCID: PMC6616588 DOI: 10.3390/jcm8060830

Abstract

In critically ill children admitted to pediatric intensive care units (PICUs), enteral nutrition (EN) is often delayed due to gastrointestinal dysfunction or interrupted. Since a macronutrient deficit in these patients has been associated with adverse outcomes in observational studies, supplemental parenteral nutrition (PN) in PICUs has long been widely advised to meeting nutritional requirements. However, uncertainty of timing of initiation, optimal dose and composition of PN has led to a wide variation in previous guidelines and current clinical practices. The PEPaNIC (Early versus Late Parenteral Nutrition in the Pediatric ICU) randomized controlled trial recently showed that withholding PN in the first week in PICUs reduced incidence of new infections and accelerated recovery as compared with providing supplemental PN early (within 24 hours after PICU admission), irrespective of diagnosis, severity of illness, risk of malnutrition or age. The early withholding of amino acids in particular, which are powerful suppressors of intracellular quality control by autophagy, statistically explained this outcome benefit. Importantly, two years after PICU admission, not providing supplemental PN early in PICUs did not negatively affect mortality, growth or health status, and significantly improved neurocognitive development. These findings have an important impact on the recently issued guidelines for PN administration to critically ill children. In this review, we summarize the most recent literature that provides evidence on the implications for clinical practice with regard to the use of early supplemental PN in critically ill children.

Keywords: Pediatric Intensive Care Unit; critical illness; early parenteral nutrition; enteral nutrition

References

  1. Exp Eye Res. 2001 Aug;73(2):221-8 - PubMed
  2. J Nutr. 2002 Oct;132(10):3225S-7S - PubMed
  3. Intensive Care Med. 2004 Sep;30(9):1807-13 - PubMed
  4. Proc Natl Acad Sci U S A. 2004 Dec 7;101(49):17312-5 - PubMed
  5. J Pediatr Gastroenterol Nutr. 2005 Nov;41 Suppl 2:S1-87 - PubMed
  6. Pediatr Crit Care Med. 2006 Mar;7(2):147-53 - PubMed
  7. Crit Care Med. 2006 Sep;34(9 Suppl):S183-90 - PubMed
  8. Annu Rev Nutr. 2007;27:363-88 - PubMed
  9. Methods Mol Biol. 2008;445:89-109 - PubMed
  10. Lancet. 2009 Feb 14;373(9663):547-56 - PubMed
  11. Cochrane Database Syst Rev. 2009 Apr 15;(2):CD005144 - PubMed
  12. JPEN J Parenter Enteral Nutr. 2009 May-Jun;33(3):260-76 - PubMed
  13. JPEN J Parenter Enteral Nutr. 2010 Jan-Feb;34(1):38-45 - PubMed
  14. Pediatr Crit Care Med. 2010 Sep;11(5):549-55 - PubMed
  15. Crit Care. 2010;14(3):R124 - PubMed
  16. Arch Dis Child. 2011 Sep;96(9):863-9 - PubMed
  17. N Engl J Med. 2011 Aug 11;365(6):506-17 - PubMed
  18. Aggress Behav. 2011 Sep-Oct;37(5):476-88 - PubMed
  19. Endocrinology. 2012 May;153(5):2267-76 - PubMed
  20. PLoS One. 2012;7(3):e31821 - PubMed
  21. Crit Care Med. 2012 Jul;40(7):2204-11 - PubMed
  22. JAMA. 2012 Oct 24;308(16):1641-50 - PubMed
  23. Int J Dev Neurosci. 2013 Oct;31(6):382-90 - PubMed
  24. J Am Soc Nephrol. 2013 May;24(6):995-1005 - PubMed
  25. JAMA Neurol. 2013 Jun;70(6):703-10 - PubMed
  26. Intensive Care Med. 2013 Sep;39(9):1584-93 - PubMed
  27. Nat Rev Immunol. 2013 Oct;13(10):722-37 - PubMed
  28. Crit Care Med. 2014 Apr;42(4):849-59 - PubMed
  29. Pediatr Crit Care Med. 2014 Mar;15(3):189-96 - PubMed
  30. Lancet Respir Med. 2013 Oct;1(8):621-629 - PubMed
  31. Indian J Crit Care Med. 2013 Nov;17(6):343-9 - PubMed
  32. Crit Care Med. 2014 Sep;42(9):2101-8 - PubMed
  33. BMJ. 2014 Dec 02;349:g6674 - PubMed
  34. Pediatrics. 2015 Feb;135(2):e289-91 - PubMed
  35. Intensive Care Med. 2015 Jul;41(7):1235-46 - PubMed
  36. Intensive Care Med. 2015 Jul;41(7):1197-208 - PubMed
  37. Am J Clin Nutr. 2015 Jul;102(1):199-206 - PubMed
  38. Acta Paediatr. 2016 Feb;105(2):e60-6 - PubMed
  39. Nutr J. 2015 Oct 06;14:103 - PubMed
  40. Pediatr Crit Care Med. 2016 Jan;17(1):10-8 - PubMed
  41. Open Heart. 2015 Oct 29;2(1):e000255 - PubMed
  42. JPEN J Parenter Enteral Nutr. 2016 Aug;40(6):795-805 - PubMed
  43. Clin Nutr. 2017 Feb;36(1):218-223 - PubMed
  44. Intensive Care Med. 2016 Mar;42(3):379-392 - PubMed
  45. Science. 2015 Dec 4;350(6265):1193-8 - PubMed
  46. Curr Opin Clin Nutr Metab Care. 2016 May;19(3):226-33 - PubMed
  47. N Engl J Med. 2016 Mar 24;374(12):1111-22 - PubMed
  48. Cochrane Database Syst Rev. 2016 May 27;(5):CD005144 - PubMed
  49. Curr Opin Crit Care. 2016 Aug;22(4):316-24 - PubMed
  50. N Engl J Med. 2016 Jul 28;375(4):384 - PubMed
  51. N Engl J Med. 2016 Jul 28;375(4):384-5 - PubMed
  52. J Thorac Dis. 2016 Aug;8(8):1877-9 - PubMed
  53. Ann Nutr Metab. 2017;70(1):34-38 - PubMed
  54. Nutr Clin Pract. 2017 Apr;32(1_suppl):128S-141S - PubMed
  55. Lancet Respir Med. 2017 Jun;5(6):475-483 - PubMed
  56. Clin Nutr ESPEN. 2016 Oct;15:80-84 - PubMed
  57. Pediatr Crit Care Med. 2017 Jul;18(7):675-715 - PubMed
  58. Intensive Care Med. 2017 Nov;43(11):1637-1647 - PubMed
  59. Intensive Care Med. 2018 May;44(5):649-651 - PubMed
  60. Pharmacol Res. 2018 Apr;130:127-131 - PubMed
  61. Crit Care. 2018 Jan 15;22(1):4 - PubMed
  62. Crit Care. 2018 Feb 21;22(1):38 - PubMed
  63. Clin Nutr ESPEN. 2018 Apr;24:41-46 - PubMed
  64. Nat Rev Endocrinol. 2018 Jun;14(6):345-355 - PubMed
  65. Clin Nutr. 2018 Dec;37(6 Pt B):2315-2323 - PubMed
  66. Lancet Child Adolesc Health. 2018 Jul;2(7):505-515 - PubMed
  67. Lancet Respir Med. 2019 Feb;7(2):141-153 - PubMed
  68. Crit Care. 2018 Oct 25;22(1):261 - PubMed
  69. JAMA. 2018 Sep 11;320(10):969-970 - PubMed
  70. JAMA Netw Open. 2018 Sep 7;1(5):e182668 - PubMed
  71. Clin Nutr. 2019 Mar 4;:null - PubMed
  72. JPEN J Parenter Enteral Nutr. 1985 May-Jun;9(3):309-13 - PubMed
  73. Lancet. 1997 Apr 26;349(9060):1213-7 - PubMed
  74. Crit Care Med. 1997 Oct;25(10):1637-42 - PubMed

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