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paediatric critical care nutrition

Jan Hau Lee, Elizabeth Rogers, Yek Kee Chor, Rujipat Samransamruajkit, Pei Lin Koh, Mohamad Miqdady, Ali Ibrahim Al-Mehaidib, Antonius Pudjiadi, Sunit Singhi, Nilesh M Mehta
BACKGROUND AND OBJECTIVES: Current practices and available resources for nutrition therapy in paediatric intensive care units (PICUs) in the Asia Pacific-Middle East region are expected to differ from western countries. Existing guidelines for nutrition management in critically ill children may not be directly applicable in this region. This paper outlines consensus statements developed by the Asia Pacific-Middle East Consensus Working Group on Nutrition Therapy in the Paediatric Critical Care Environment...
December 2016: Asia Pacific Journal of Clinical Nutrition
Mònica Balaguer, Iolanda Jordan
No abstract text is available yet for this article.
August 2016: Journal of Thoracic Disease
Alethea Tan, Sarah Smailes, Thessa Friebel, Ashish Magdum, Quentin Frew, Naguib El-Muttardi, Peter Dziewulski
Burn survival has improved with advancements in fluid resuscitation, surgical wound management, wound dressings, access to antibiotics and nutritional support for burn patients. Despite these advancements, the presence of smoke inhalation injury in addition to a cutaneous burn still significantly increases morbidity and mortality. The pathophysiology of smoke inhalation has been well studied in animal models. Translation of this knowledge into effectiveness of clinical management and correlation with patient outcomes including the paediatric population, is still limited...
August 2016: Burns: Journal of the International Society for Burn Injuries
Ari Joffe, Natalie Anton, Laurance Lequier, Ben Vandermeer, Lisa Tjosvold, Bodil Larsen, Lisa Hartling
BACKGROUND: Nutritional support in the critically ill child has not been well investigated and is a controversial topic within paediatric intensive care. There are no clear guidelines as to the best form or timing of nutrition in critically ill infants and children. This is an update of a review that was originally published in 2009. . OBJECTIVES: The objective of this review was to assess the impact of enteral and parenteral nutrition given in the first week of illness on clinically important outcomes in critically ill children...
2016: Cochrane Database of Systematic Reviews
Juan Carlos Flores Cano, Macarena Lizama Calvo, Natalie Rodríguez Zamora, María Eugenia Ávalos Anguita, Mónica Galanti De La Paz, Salesa Barja Yañez, Carlos Becerra Flores, Carolina Sanhueza Sepúlveda, Ana María Cabezas Tamayo, Jorge Orellana Welch, Gisela Zillmann Geerdts, Rosa María Antilef, Alfonso Cox Melane, Marcelo Valle Maluenda, Nelson Vargas Catalán
"Children with special health care needs" (CSHCN) is an emerging and heterogeneous group of paediatric patients, with a wide variety of medical conditions and with different uses of health care services. There is consensus on how to classify and assess these patients according to their needs, but not for their specific diagnosis. Needs are classified into 6 areas: a) specialised medical care; b) use or need of prescription medication; c) special nutrition; d) dependence on technology; e) rehabilitation therapy for functional limitation; and f) special education services...
May 2016: Revista Chilena de Pediatría
Judith J M Wong, Chengsi Ong, Wee Meng Han, Nilesh M Mehta, Jan Hau Lee
BACKGROUND AND OBJECTIVES: Nutrition is a fundamental component of care of critically ill children. Determining variation in nutritional practices within paediatric intensive care units (PICUs) allows for review and improvement of nutrition practices. METHODS AND STUDY DESIGN: The aim was to survey the nutrition practices and perspectives of paediatric intensivists and dieticians in Asia-Pacific and the Middle East. A questionnaire was developed to collect data on (1) the respondent's and institution's characteristics, (2) nutritional assessments and nutrient delivery practices, and (3) the perceived importance and barriers to optimal enteral feeding in the PICU...
2016: Asia Pacific Journal of Clinical Nutrition
Koen Joosten, Esther van Puffelen, Sascha Verbruggen
PURPOSE OF REVIEW: This article describes the current best available evidence on optimal nutrition in the paediatric intensive care based on different levels of outcome, which can be divided in surrogate and hard clinical outcome parameters. RECENT FINDINGS: Undernutrition is associated with increased morbidity and mortality, whereas in specific cohorts of critically ill children, such as those with burn injury, obesity is associated with more complications, longer length of stay, and decreased likelihood of survival...
March 2016: Current Opinion in Clinical Nutrition and Metabolic Care
Dick D Chamla, Shaffiq Essajee, Mark Young, Scott Kellerman, Ronnie Lovich, Nandita Sugandhi, Anouk Amzel, Chewe Luo
INTRODUCTION: Integration of HIV into child survival platforms is an evolving territory with multiple connotations. Most literature on integration of HIV into other health services focuses on adults; however promising practices for children are emerging. These include the Double Dividend (DD) framework, a new programming approach with dual goal of improving paediatric HIV care and child survival. In this commentary, the authors discuss why integrating HIV testing, treatment and care into child survival platforms is important, as well as its potential to advance progress towards global targets that call for, by 2020, 90% of children living with HIV to know their status, 90% of those diagnosed to be on treatment and 90% of those on treatment to be virally suppressed (90-90-90)...
2015: Journal of the International AIDS Society
Alicja Bartkowska-Śniatkowska, Marzena Zielińska, Magdalena Świder, Grażyna Bittner, Irena Sarnowska-Wroczyńska, Katarzyna Witulska, Marek Migdał, Andrzej Piotrowski, Krystyna Bober-Olesińska, Marcin Kęsiak, Ryszard Lauterbach, Agnieszka Gawecka, Mikołaj Danko, Katarzyna Popińska, Hanna Romanowska, Agnieszka Szlagatys-Sidorkiewicz, Ewa Toporowska-Kowalska, Aleksandra Żyła, Janusz Książyk
Providing nutritional therapy via the gastrointestinal tract in patients in paediatric intensive care units (PICUs) is an effective method for delivering energy and other nutrients. In the event of contraindications to using this method, it is necessary to commence parenteral nutrition. In the present study, methods for nutritional treatments in critically ill children are presented, depending on the clinical situation.
2015: Anaesthesiology Intensive Therapy
Mark Tighe, Nadeem A Afzal, Amanda Bevan, Andrew Hayen, Alasdair Munro, R Mark Beattie
BACKGROUND: Gastro-oesophageal reflux (GOR) is a common disorder, characterised by regurgitation of gastric contents into the oesophagus. GOR is a very common presentation in infancy in both primary and secondary care settings. GOR can affect approximately 50% of infants younger than three months old (Nelson 1997). The natural history of GOR in infancy is generally that of a functional, self-limiting condition that improves with age; < 5% of children with vomiting or regurgitation continue to have symptoms after infancy (Martin 2002)...
2014: Cochrane Database of Systematic Reviews
Jackie Mara, Emma Gentles, Hani A Alfheeaid, Krystalia Diamantidi, Neil Spenceley, Mark Davidson, David Young, Konstantinos Gerasimidis
BACKGROUND: Provision of optimal nutrition in children in critical care is often challenging. This study evaluated exclusive enteral nutrition (EN) provision practices and explored predictors of energy intake and delay of EN advancement in critically ill children. METHODS: Data on intake and EN practices were collected on a daily basis and compared against predefined targets and dietary reference values in a paediatric intensive care unit. Factors associated with intake and advancement of EN were explored...
2014: BMC Pediatrics
Enid E Martinez, Lori J Bechard, Nilesh M Mehta
BACKGROUND: Enteral nutrition (EN) delivery is associated with improved outcomes in critically ill patients. We aimed to describe EN practices, including details of algorithms and individual bedside practices, in pediatric intensive care units (PICUs). METHODS: Available EN algorithm details from 31 international PICUs were obtained. Daily nutrient intake data from 524 mechanically ventilated patients, 1 month to 18 years old, were prospectively documented, including EN delivery, adjunct therapies, and energy prescription...
June 2014: Nutrition in Clinical Practice
Rachel D'Cruz, Hugh C O Martin, Andrew J A Holland
Burns remain a leading cause of injury in the paediatric population in Australia despite efforts in prevention. Advances in surgical management include novel debridement methods and blood conserving techniques. Patients with severe burns (>20%) remain significantly more complex to manage as a result of extensive alterations in metabolic processes. There appears increasing evidence to support the use of pharmacological modulators of the hyper-metabolic state in these patients. The management of a child with burns involves acute, subacute and long-term planning...
September 2013: Journal of Paediatrics and Child Health
Mark E Ralston, Louise T Day, Tina M Slusher, Ndidiamaka L Musa, Helen S Doss
Nearly all global mortality in children younger than 5 years (99%) occurs in developing countries. The leading causes of mortality in children younger than 5 years worldwide, pneumonia and diarrhoeal illness, account for 1·396 and 0·801 million annual deaths, respectively. Although important advances in prevention are being made, advanced life support management in children in developing countries is often incomplete because of limited resources. Existing advanced life support management guidelines for children in limited-resource settings are mainly empirical, rather than evidence-based, written for the hospital setting, not standardised with a systematic approach to patient assessment and categorisation of illness, and taught in current paediatric advanced life support training courses from the perspective of full-resource settings...
January 19, 2013: Lancet
B V Vijetha, Shikha Mehra, K Swarupa, K Lakshman
Malnutrition is quite common in hospitalised patients, with most studies indicating a prevalence of 20-62%. It is associated with length of stay and morbidity in developed countries. This study was performed to identify nutritional status of hospitalised patients in urban corporate setting by using primarily, the Mini Nutritional Assessment tool. This is a prospective study conducted in an urban tertiary care centre. 304 consecutive patients admitted to the hospital were studied, between the dates of July 2007 and September 2007...
April 2009: Indian Journal of Surgery
Nedim Hadzic
The only effective treatment for 'failing' Kasai portoenterostomy is liver transplantation (LT). However, to maximise a patient's chances to achieve the proclaimed >95% survival with sequential surgical management, medical follow-up and treatment must be planned carefully. This includes routine fat-soluble vitamin supplementation with choleretics, aggressive nutritional support, regular ultrasonography, optimal general paediatric care, and psychological support for the family once complications arise. Careful timing of LT is of critical importance, although recent trends include earlier consideration of LT in children with biliary atresia...
November 2012: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Eduardo Duniec, Mical Raz
In 1951 John Bowlby, British psychoanalyst and child psychiatrist, published his now famous report, Maternal Care and Mental Health, commissioned by the World Health Organization. In this report, Bowlby coined the term 'maternal deprivation', which quickly permeated into Western psychiatry and psychology. The implications of Bowlby's writings, while widely criticized and contested, generated a considerable amount of research and brought about significant changes in perceptions of separation between children and their mothers...
March 2011: History of Psychiatry
Carlijn T de Betue, Dick A van Waardenburg, Nicolaas E Deutz, Hans M van Eijk, Johannes B van Goudoever, Yvette C Luiking, Luc J Zimmermann, Koen F Joosten
OBJECTIVE: The preservation of nutritional status and growth is an important aim in critically ill infants, but difficult to achieve due to the metabolic stress response and inadequate nutritional intake, leading to negative protein balance. This study investigated whether increasing protein and energy intakes can promote anabolism. The primary outcome was whole body protein balance, and the secondary outcome was first pass splanchnic phenylalanine extraction (SPE(Phe)). DESIGN: This was a double-blind randomised controlled trial...
September 2011: Archives of Disease in Childhood
Kalia P Ulate
OBJECTIVE: To review findings and discuss implications of strict glycemic control in children. DESIGN: Critical appraisal of a randomized controlled trial. FINDINGS: This is the largest prospective randomized controlled trial to date, comparing intensive insulin therapy (glycemic targets: 50.4-79.2 mg/dL [2.8-4.4 mmol/L] and 70.2-99 mg/dL [3.9-5.5 mmol/L] [for infants and children, respectively]) and conventional insulin therapy (target: 180-215 mg/dl [10-11...
July 2011: Pediatric Critical Care Medicine
Marta Botrán, Jesús López-Herce, Santiago Mencía, Javier Urbano, Maria José Solana, Ana García, Angel Carrillo
The objective of the present study was to investigate the relationship between energy expenditure (EE), biochemical and anthropometric nutritional status and severity scales in critically ill children. We performed a prospective observational study in forty-six critically ill children. The following variables were recorded before starting nutrition: age, sex, diagnosis, weight, height, risk of mortality according to the Paediatric Risk Score of Mortality (PRISM), the Revised Paediatric Index of Mortality (PIM2) and the Paediatric Logistic Organ Dysfunction (PELOD) scales, laboratory parameters (albumin, total proteins, prealbumin, transferrin, retinol-binding protein, cholesterol and TAG, and nitrogen balance) and EE measured by indirect calorimetry...
March 2011: British Journal of Nutrition
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