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nutrition and pediatric critical care

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https://www.readbyqxmd.com/read/28549221/preventing-underfeeding-and-overfeeding-a-clinician-s-guide-to-the-acquisition-and-implementation-of-indirect-calorimetry
#1
Amy K Ladd, Heather E Skillman, Matthew A Haemer, Peter M Mourani
BACKGROUND: In critically ill patients, indirect calorimetry (IC) is the gold standard to determine energy needs, as the use of predictive equations can result in underfeeding or overfeeding. The aim of this quality improvement (QI) initiative was to describe the rationale for and implementation of a process to target energy provision according to IC measurements in a tertiary academic medical center pediatric intensive care unit (PICU). MATERIALS AND METHODS: To justify the purchase of an indirect calorimeter for clinical use, a needs assessment was conducted, followed by a training and implementation period...
May 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28376054/timing-of-the-initiation-of-parenteral-nutrition-in-critically-ill-children
#2
Lissette Jimenez, Nilesh M Mehta, Christopher P Duggan
PURPOSE OF REVIEW: To review the current literature evaluating clinical outcomes of early and delayed parenteral nutrition initiation among critically ill children. RECENT FINDINGS: Nutritional management remains an important aspect of care among the critically ill, with enteral nutrition generally preferred. However, inability to advance enteral feeds to caloric goals and contraindications to enteral nutrition often leads to reliance on parenteral nutrition. The timing of parenteral nutrition initiation is varied among critically ill children, and derives from an assessment of nutritional status, energy requirements, and physiologic differences between adults and children, including higher nutrient needs and lower body reserves...
May 2017: Current Opinion in Clinical Nutrition and Metabolic Care
https://www.readbyqxmd.com/read/28267681/pressure-ulcer-risk-and-prevention-practices-in-pediatric-patients-a-secondary-analysis-of-data-from-the-national-database-of-nursing-quality-indicators%C3%A2
#3
Ivy Razmus, Sandra Bergquist-Beringer
Little is known about pressure ulcer prevention practice among pediatric patients. To describe the frequency of pressure ulcer risk assessment in pediatric patients and pressure ulcer prevention intervention use overall and by hospital unit type, a descriptive secondary analysis was performed of data submitted to the National Database for Nursing Quality Indicators® (NDNQI®) for at least 3 of the 4 quarters in 2012. Relevant data on pressure ulcer risk from 271 hospitals across the United States extracted from the NDNQI database included patient skin and pressure ulcer risk assessment on admission, time since the last pressure ulcer risk assessment, method used to assess pressure ulcer risk, and risk status...
January 2017: Ostomy/wound Management
https://www.readbyqxmd.com/read/28248836/pediatric-multiple-organ-dysfunction-syndrome-promising-therapies
#4
Allan Doctor, Jerry Zimmerman, Michael Agus, Surender Rajasekaran, Juliane Bubeck Wardenburg, James Fortenberry, Anne Zajicek, Emma Mairson, Katri Typpo
OBJECTIVE: To describe the state of the science, identify knowledge gaps, and offer potential future research questions regarding promising therapies for children with multiple organ dysfunction syndrome presented during the Eunice Kennedy Shriver National Institute of Child Health and Human Development Workshop on Pediatric Multiple Organ Dysfunction Syndrome (March 26-27, 2015). DATA SOURCES: Literature review, research data, and expert opinion. STUDY SELECTION: Not applicable...
March 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28089618/24-hour-protein-arginine-and-citrulline-metabolism-in-fed-critically-ill-children-a-stable-isotope-tracer-study
#5
Carlijn T I de Betue, Xiomara C Garcia Casal, Dick A van Waardenburg, Stephen M Schexnayder, Koen F M Joosten, Nicolaas E P Deutz, Marielle P K J Engelen
BACKGROUND & AIMS: The reference method to study protein and arginine metabolism in critically ill children is measuring plasma amino acid appearances with stable isotopes during a short (4-8 h) time period and extrapolate results to 24-h. However, 24-h measurements may be variable due to critical illness related factors and a circadian rhythm could be present. Since only short duration stable isotope studies in critically ill children have been conducted before, the aim of this study was to investigate 24-h appearance of specific amino acids representing protein and arginine metabolism, with stable isotope techniques in continuously fed critically ill children...
June 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28079529/leveraging-the-skills-of-nurses-and-the-power-of-language-nutrition-to-ensure-a-better-future-for-children
#6
REVIEW
Ashley Darcy Mahoney, Lauren Head Zauche, Sunny Hallowell, Arianne Weldon, Jennifer Stapel-Wax
BACKGROUND: Early language exposure is critical for language acquisition and significantly influences a child's literacy skills. However, preterm infants may experience language deprivation in the neonatal intensive care unit. Nurses are vital to helping parents understand their critical role in early language development. PURPOSE: To discuss the impact of language-rich interactions and interventions that promote early language exposure, or Language Nutrition, by parents and caregivers on the long-term developmental, language, and educational outcomes of high-risk infants...
February 2017: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/27989360/complications-in-neonatal-surgery
#7
REVIEW
Mauricio A Escobar, Michael G Caty
Neonatal surgery is recognized as an independent discipline in general surgery, requiring the expertise of pediatric surgeons to optimize outcomes in infants with surgical conditions. Survival following neonatal surgery has improved dramatically in the past 60 years. Improvements in pediatric surgical outcomes are in part attributable to improved understanding of neonatal physiology, specialized pediatric anesthesia, neonatal critical care including sophisticated cardiopulmonary support, utilization of parenteral nutrition and adjustments in fluid management, refinement of surgical technique, and advances in surgical technology including minimally invasive options...
December 2016: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/27913773/pediatric-nutrition-assessment-anthropometrics-to-zinc
#8
Kelly Green Corkins, Erin E Teague
Pediatric patients with chronic illnesses or diseases or who require long-term nutrition support are most vulnerable to nutrition-related issues. Malnutrition in a pediatric patient may negatively affect long-term growth and development. Children also become malnourished much more quickly than adults. A comprehensive nutrition assessment that includes food and nutrition-related history, anthropometric measurements, biochemical data, medical tests and procedures, nutrition-focused physical findings, and patient history should be completed on these patients as no one parameter is a comprehensive indicator of nutrition status...
December 2, 2016: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/27856012/nutrient-delivery-in-mechanically-ventilated-surgical-patients-in-the-pediatric-critical-care-unit
#9
Cristine S Velazco, David Zurakowski, Brenna S Fullerton, Lori J Bechard, Tom Jaksic, Nilesh M Mehta
PURPOSE: Inadequate nutrient intake is associated with poor outcomes in critically ill children. We examined macronutrient delivery in surgical patients in the pediatric intensive care unit (PICU). METHODS: In a prospective international cohort study of mechanically ventilated children (1month to 18years), we recorded adequacy of cumulative nutrient delivery in the PICU. Surgical patients enrolled in this study were included in the current analysis. Protein intake <60% of the prescribed goal was deemed inadequate...
January 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27790606/nutrition-a-primary-therapy-in-pediatric-acute-respiratory-distress-syndrome
#10
REVIEW
Bryan Wilson, Katri Typpo
Appropriate nutrition is an essential component of intensive care management of children with acute respiratory distress syndrome (ARDS) and is linked to patient outcomes. One out of every two children in the pediatric intensive care unit (PICU) will develop malnutrition or have worsening of baseline malnutrition and present with specific micronutrient deficiencies. Early and adequate enteral nutrition (EN) is associated with improved 60-day survival after pediatric critical illness, and, yet, despite early EN guidelines, critically ill children receive on average only 55% of goal calories by PICU day 10...
2016: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/27770486/nutritional-status-and-weakness-following-pediatric-hematopoietic-cell-transplantation
#11
Sandra Bouma, Mark Peterson, Erin Gatza, Sung Won Choi
Survivorship after pediatric HCT has increased over the past decade. Focus on long-term care and well-being remains critical due to risk of poor dietary habits and exaggerated sedentary behavior, which can lead to muscle weakness, increased risk for obesity, and cardiometabolic disorders. Nutrition and physical activity are key factors in survivorship; however, data are limited. Comprehensive nutritional assessments, including nutrition-focused physical examination, grip strength, and food/activity surveys, were completed in 36 pediatric HCT survivors (aged 2-25 years)...
December 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27660289/interaction-between-2-nutraceutical-treatments-and-host-immune-status-in-the-pediatric-critical-illness-stress-induced-immune-suppression-comparative-effectiveness-trial
#12
Joseph A Carcillo, J Michael Dean, Richard Holubkov, John Berger, Kathleen L Meert, Kanwaljeet J S Anand, Jerry J Zimmerman, Christopher J L Newth, Rick Harrison, Jeri Burr, Douglas F Willson, Carol Nicholson, Michael J Bell, Robert A Berg, Thomas P Shanley, Sabrina M Heidemann, Heidi Dalton, Tammara L Jenkins, Allan Doctor, Angie Webster, Robert F Tamburro
BACKGROUND AND AIMS: The pediatric Critical Illness Stress-induced Immune Suppression (CRISIS) trial compared the effectiveness of 2 nutraceutical supplementation strategies and found no difference in the development of nosocomial infection and sepsis in the overall population. We performed an exploratory post hoc analysis of interaction between nutraceutical treatments and host immune status related to the development of nosocomial infection/sepsis. METHODS: Children from the CRISIS trial were analyzed according to 3 admission immune status categories marked by decreasing immune competence: immune competent without lymphopenia, immune competent with lymphopenia, and previously immunocompromised...
September 22, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/27596080/-current-situation-of-enteral-nutrition-interruptions-in-sepsis-children-in-pediatric-intensive-care-unit
#13
B L Fang, S Y Qian, X L Jia, Z Li, J Liu
OBJECTIVE: To analyze the interruptions of enteral nutrition (EN) and it's relationship to prognosis in children with sepsis in pediatric intensive care unit (PICU). METHOD: Daily EN intake and reasons for EN interruptions were prospectively observed and recorded in children with sepsis who were admitted to our PICU from November 2012 to April 2013. Clinical prognosis was compared between children with and without EN interruptions by t, rank-sum and χ(2) tests...
September 2016: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/27490606/nutrition-and-mesenteric-issues-in-pediatric-cardiac-critical-care
#14
Alejandro A Floh, Julie Slicker, Steven M Schwartz
OBJECTIVES: The objectives of this review are to discuss the challenges of delivering adequate nutrition to children with congenital heart disease, including pre- and postoperative factors and the role of enteral and parenteral nutrition, as well as the evidence supporting current practices. DATA SOURCE: MEDLINE and PubMed. CONCLUSION: Providing adequate nutritional support is paramount for critically ill infants with congenital heart disease, a population at particular risk for malnutrition...
August 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27364223/nutritional-status-as-a-predictor-of-duration-of-mechanical-ventilation-in-critically-ill-children
#15
Rafaela B Grippa, Paola S Silva, Eliana Barbosa, Nilzete L Bresolin, Nilesh M Mehta, Yara M F Moreno
OBJECTIVES: Critically ill children admitted to the pediatric intensive care unit (PICU) often are malnourished. The aim of this study was to determine the role of nutritional status on admission as a predictor of the duration of mechanical ventilation in critically ill children. METHODS: This was a single-center, prospective cohort study, including consecutive children (ages 1 mo to 15 y) admitted to a PICU. Demographic characteristics, clinical characteristics, and nutritional status were recorded and patients were followed up until hospital discharge...
January 2017: Nutrition
https://www.readbyqxmd.com/read/27329387/acute-abdominal-pain-as-a-presenting-symptom-of-beriberi-in-a-pediatric-patient
#16
Roberto J N Nogueira, José E Godoy, Tiago H Souza
Vitamin B1 (thiamine) plays a fundamental role in the proper functioning of the nervous and cardiovascular systems and in glucose metabolism. Because of the inability of the human body to store large amounts of vitamin, continuous restoration through diet is necessary. In the pediatric population, thiamine deficiency has a broad spectrum of clinical presentations, making diagnosis difficult. In this article, we report the case of a 7-month-old child with thiamine deficiency presented with neurological symptoms and simulation of acute abdomen...
December 2016: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/27309970/the-science-and-art-of-pediatric-critical-care-nutrition
#17
Enid E Martinez, Nilesh M Mehta
PURPOSE OF REVIEW: Nutritional status and nutrient delivery during critical illness impact clinical outcomes. We have reviewed recent studies that may guide best practices regarding nutrition therapy in critically ill children. RECENT FINDINGS: Malnutrition is prevalent in the pediatric ICU population, and is associated with worse outcomes. Nutrition support teams, dedicated dietitians, and educational programs facilitate surveillance for existing malnutrition and nutrition risk, but specific tools for the pediatric ICU population are lacking...
August 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27230550/nutritional-support-for-critically-ill-children
#18
REVIEW
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
https://www.readbyqxmd.com/read/27197737/critical-dietary-habits-in-early-childhood-principles-and-practice
#19
REVIEW
Mathilde Kersting, Ute Alexy, Susanne Schürmann
The adequacy of a diet is usually evaluated based on nutrient intake. As people eat foods but not nutrients, food-based dietary guidelines (FBDG) are needed. To evaluate dietary habits in infants and young children, the following stepwise approach is suggested: (1) develop country-specific FBDG to identify the potential of common nonfortified foods to ensure adequate nutrient intake and (2) examine potential 'critical' dietary patterns if main food groups are excluded, such as in vegetarian diets or if a family's precarious social status leads to food constraints...
2016: World Review of Nutrition and Dietetics
https://www.readbyqxmd.com/read/27184280/is-there-a-role-for-the-enteral-administration-of-serum-derived-immunoglobulins-in-human-gastrointestinal-disease-and-pediatric-critical-care-nutrition
#20
REVIEW
Melissa Van Arsdall, Ikram Haque, Yuying Liu, J Marc Rhoads
Twenty years ago, there was profound, international interest in developing oral human, bovine, or chicken egg-derived immunoglobulin (Ig) for the prevention and nutritional treatment of childhood malnutrition and gastrointestinal disease, including acute diarrhea and necrotizing enterocolitis. Although such Ig products were shown to be effective, with both nutritional and antidiarrheal benefits, interest waned because of their cost and because of the perceived risk of bovine serum encephalitis (BSE). BSE is no longer considered a barrier to use of oral Ig, because the WHO has declared the United States to be BSE-free since the early 2000s...
May 2016: Advances in Nutrition
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