Effect of late versus early initiation of parenteral nutrition on weight deterioration during PICU stay: Secondary analysis of the PEPaNIC randomised controlled trial
| Autor: | E. van Puffelen, Ilse Vanhorebeek, Koen F. M. Joosten, Sascha Verbruggen, G Van den Berghe, Karolijn Dulfer, Jessie M. Hulst |
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| Přispěvatelé: | Pediatric Surgery, Pediatrics |
| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Male Pediatrics medicine.medical_specialty Parenteral Nutrition Time Factors Critical Care Critical Illness 030209 endocrinology & metabolism Critical Care and Intensive Care Medicine Lower risk Intensive Care Units Pediatric Early initiation law.invention 03 medical and health sciences 0302 clinical medicine Nosocomial infection Randomized controlled trial Nutritional status law Secondary analysis Medicine Humans Pediatric intensive care unit Child Emaciation 030109 nutrition & dietetics Nutrition and Dietetics business.industry Critically ill Infant Parenteral nutrition Weight Intensive care unit 3. Good health Child Preschool Female business |
| Zdroj: | Clinical Nutrition, 39(1), 104-109. Churchill Livingstone Clinical Nutrition |
| ISSN: | 1532-1983 0261-5614 |
| Popis: | BACKGROUND & AIMS: Critically ill children are at increased risk of weight deterioration in the paediatric intensive care unit (PICU). Whether early initiation of parenteral nutrition (PN) prevents weight deterioration is unknown. The aims of this study were to assess the effect of withholding supplemental PN during the first week on weight Z-score change in PICU and to evaluate the association between weight Z-score change in the PICU and clinical outcomes. METHODS: This is a secondary analysis of the Paediatric Early versus Late Parenteral Nutrition in Intensive Care Unit (PEPaNIC) randomised controlled trial (N = 1440), which focused on the subgroup of patients with longitudinal weight Z-scores available on admission and on the last day in PICU. Patients were randomly allocated to initiation of supplemental PN after one week (Late-PN) or within 24 h (Early-PN) when enteral nutrition was insufficient. The effect of Late-PN versus Early-PN on the change in weight Z-score was investigated, adjusted for risk factors. Moreover, the association between weight Z-score change and clinical outcomes was explored, adjusted for risk factors. RESULTS: Longitudinal weight Z-scores were available for 470 patients. Enteral nutrition intake was equal in the Early-PN and Late-PN group. Less weight Z-score deterioration during PICU stay was associated with a lower risk of new infections (adjusted OR per Z-score increase 0.72 [0.55-0.96], p = 0.02), and with a higher likelihood of an earlier discharge from PICU alive (adjusted HR per Z-score increase 1.22 [1.10-1.37], p |
| Databáze: | OpenAIRE |
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