Pediatric International Nutrition Study 2018
Research type
Research Study
Full title
Pediatric International Nutrition Study 2018 - a prospective multicenter cohort study of nutritional practices and outcomes in pediatric intensive care units around the world
IRAS ID
233208
Contact name
Lori Bechard
Contact email
Sponsor organisation
Boston Children's Hospital
Duration of Study in the UK
0 years, 11 months, 3 days
Research summary
Optimal nutrition support during paediatric critical illness is a fundamental goal of critical care that requires careful assessment, appropriate prescription, and provision of macronutrients and micronutrients. Despite documentation of important benefits, a significant proportion of patients in PICUs fail to achieve prescribed nutrient intake.1,2 Discrepancies between delivered and prescribed nutrient intake have been associated with important clinical outcomes.1,2 In an Australian study, only 52% of patients received calories to meet their estimated energy requirement(EER) at any time during their PICU course, and a significant decline in weight for age Z-scores was observed.3 Variation from prescribed feeding volumes has been described for reasons including gut dysfunction, feeding interruptions for procedures and mechanical problems with feeding tubes.4,5 Failure to accurately assess, correctly prescribe and consistently deliver the proper amount of calories during critical illness may lead to energy imbalance.6,7 Patients with large energy deficits have been reported to have higher rates of multiple-organ dysfunction 8.
Existing deficiencies in nutrition practice may be avoidable, and result in increased length of PICU stay, use of PN, costs and failure to reach energy goals.5
Identification of the prescription and delivery of nutrients to critically ill children and their associations with provider characteristics, patient characteristics, and practice patterns across a broad spectrum of PICUs is necessary to further understand the relationship between nutritional status, nutrient intake, and clinical outcomes. In a multisite network, previous studies discovered important deficiencies in nutrient adequacy,7 relationships between route of nutrition and mortality,5 and a significant association between adequacy of enteral protein intake and mortality after adjustment for relevant covariates,2 with persistent inadequacy of enteral protein delivery, especially in surgical patients.9 The current study will aim to verify these important findings with updated methods, exploring additional relationships between bedside nutrient nutrient delivery, markers of nutritional status, and relevant clinical outcomes.REC name
London - City & East Research Ethics Committee
REC reference
17/LO/1639
Date of REC Opinion
25 Sep 2017
REC opinion
Favourable Opinion