Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Pediatric Critically Ill Patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition

Mehta, Nilesh M.; Skillman, Heather E.; Irving, Sharon Y.; Coss‐Bu, Jorge A.; Vermilyea, Sarah; Farrington, Elizabeth; McKeever, Liam; Hall, Amber M.; Goday, Praveen S.; Braunschweig, Carol L.

doi:10.1097/pcc.0000000000001134

Cited by 154 publications

(171 citation statements)

References 101 publications

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“…Nutritional therapy may improve prognosis and recovery, and there is no evidence of higher risks of persistent diarrhea or gastrointestinal manifestations, provided adequate diets are provided. ( 40 - 42 )…”

Section: Discussion and Critical Appraisalmentioning

confidence: 99%

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Gastrointestinal manifestations and nutritional therapy during COVID-19 pandemic: a practical guide for pediatricians

Oba¹,

Carvalho²,

Silva³

et al. 2020

Einstein (São Paulo)

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Coronavirus disease 2019 (COVID-19) is a disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which has spread globally in pandemic proportions. Accumulative evidence suggests SARS-CoV-2 can be transmitted through the digestive system, the so-called fecal-oral route of transmission, and may induce several gastrointestinal manifestations. MEDLINE ® and Embase databases were extensively searched for major clinical manifestations of gastrointestinal involvement in children and adolescents with COVID-19 reported in medical literature, and for nutritional therapy-related data. Findings and recommendations were pragmatically described to facilitate overall pediatric approach. A total of 196 studies addressing gastrointestinal or nutritional aspects associated with the global COVID-19 pandemic were found. Of these, only 17 focused specifically on pediatric patients with regard to aforementioned gastrointestinal or nutritional aspects. Most articles were descriptive and six addressed guidelines, established protocols, or expert opinions. Children and adolescents with gastrointestinal symptoms, such as nausea, vomiting and diarrhea, should be seriously suspected of COVID-19. Gastrointestinal signs and symptoms may occur in 3% to 79% of children, adolescents and adults with COVID-19, and are more common in severe cases. These include diarrhea (2% to 50%), anorexia (40% to 50%), vomiting (4% to 67%), nausea (1% to 30%), abdominal pain (2% to 6%) and gastrointestinal bleeding (4% to 14%). Patients with inflammatory bowel disease or chronic liver disease are not at greater risk of infection by SARS-CoV-2 relative to the general population. Nutritional support plays an important role in treatment of pediatric patients, particularly those with severe or critical forms of the disease. The digestive system may be a potential route of COVID-19 transmission. Further research is needed to determine whether the fecal-oral route may be involved in viral spread. Nutritional therapy is vital to prevent malnutrition and sarcopenia in severe cases.

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Section: Discussion and Critical Appraisalmentioning

confidence: 99%

“…A terapia nutricional pode contribuir para um melhor prognóstico e recuperação, e não há evidência de maiores riscos de diarreia persistente ou manifestações gastrintestinais, desde que a dieta fornecida seja adequada. ( 40 - 42 )…”

Section: Discussão E Avaliação Críticaunclassified

Gastrointestinal manifestations and nutritional therapy during COVID-19 pandemic: a practical guide for pediatricians

Oba¹,

Carvalho²,

Silva³

et al. 2020

Einstein (São Paulo)

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“…This American group proposed that malnutrition indicators namely WFH or Body Mass Index (BMI) or HFA should be used with WHO child growth standards from birth to 2 years old and CDC growth charts for children ages 2−20 years [34]. In 2017, a joint multidisciplinary task force of the ASPEN and of the Society of Critical Care Medicine published guidelines for best practice in nutrition therapy targeting critically ill patients admitted in a Pediatric Intensive Care Unit (PICU) [35]. The group recommended that upon admission in the PICU patients undergo a thorough nutritional assessment with weekly re-assessment throughout the stay.…”

Section: Succinct Historical Referencementioning

confidence: 99%

Prevalence of Malnutrition in Pediatric Hospitals in Developed and In-Transition Countries: The Impact of Hospital Practices

et al. 2019

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Presently, undernutrition still goes undetected in pediatric hospitals despite its association with poor clinical outcomes and increased annual hospital costs, thus affecting both the patient and the health care system. The reported prevalence of undernutrition in pediatric patients seeking care or hospitalized varies considerably, ranging from 2.5 to 51%. This disparity is mostly due to the diversity of the origin of populations studied, methods used to detect and assess nutritional status, as well as the lack of consensus for defining pediatric undernutrition. The prevalence among inpatients is likely to be higher than that observed for the community at large, since malnourished children are likely to have a pre-existent disease or to develop medical complications. Meanwhile, growing evidence indicates that the nutritional status of sick children deteriorates during the course of hospitalization. Moreover, the absence of systematic nutritional screening in this environment may lead to an underestimation of this condition. The present review aims to critically discuss studies documenting the prevalence of malnutrition in pediatric hospitals in developed and in-transition countries and identifying hospital practices that may jeopardize the nutritional status of hospitalized children.

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“…Withholding enteral feeds translocates gut bacteria thereby increasing the risk of sepsis. Starting of trophic feeds once lactate has normalized is a recommended strategy [ 88 ]. Parenteral nutrition is considered when there is persistent hyperlactataemia or feed intolerance taking on board the risk of infection [ 87 ].…”

Section: Discussionmentioning

confidence: 99%

Veno-arterial extracorporeal membrane oxygenation: Special reference for use in ‘post-cardiotomy cardiogenic shock’ — A review with an Indian perspective

Patangi

Shetty

Shanmugasundaram

et al. 2020

Indian J Thorac Cardiovasc Surg

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The ultimate goals of cardiovascular physiology are to ensure adequate end-organ perfusion to satisfy the local metabolic demand, to maintain homeostasis and achieve ‘milieu intérieur’. Cardiogenic shock is a state of pump failure which results in tissue hypoperfusion and its associated complications. There are a wide variety of causes which lead to this deranged physiology, and one such important and common scenario is the post-cardiotomy state which is encountered in cardiac surgical units. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is an important modality of managing post-cardiotomy cardiogenic shock with variable outcomes which would otherwise be universally fatal. VA-ECMO is considered as a double-edged sword with the advantages of luxurious perfusion while providing an avenue for the failing heart to recover, but with the problems of anticoagulation, inflammatory and adverse systemic effects. Optimal outcomes after VA-ECMO are heavily reliant on a multitude of factors and require a multi-disciplinary team to handle them. This article aims to provide an insight into the pathophysiology of VA-ECMO, cannulation techniques, commonly encountered problems, monitoring, weaning strategies and ethical considerations along with a literature review of current evidence-based practices.

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Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Pediatric Critically Ill Patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition

Cited by 154 publications

References 101 publications

Gastrointestinal manifestations and nutritional therapy during COVID-19 pandemic: a practical guide for pediatricians

Gastrointestinal manifestations and nutritional therapy during COVID-19 pandemic: a practical guide for pediatricians

Prevalence of Malnutrition in Pediatric Hospitals in Developed and In-Transition Countries: The Impact of Hospital Practices

Veno-arterial extracorporeal membrane oxygenation: Special reference for use in ‘post-cardiotomy cardiogenic shock’ — A review with an Indian perspective

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