ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: Vitamins

Braegger, Christian; Bronský, Jiří; Cai, Wei; Campoy, Cristina; Carnielli, Virgilio P.; Darmaun, Dominique; Décsi, Támas; Domellöf, Magnus; Embleton, Nicholas D.; Fewtrell, Mary; Mis, Nataša Fidler; Franz, Axel; Goulet, Olivier; Hartman, Corina; Hill, Susan; Hojsak, Iva; Iacobelli, Simona; Jochum, Frank; Joosten, Koen; Kolaček, Sanja; Koletzko, Berthold; Książyk, Janusz; Lapillonne, Alexandre; Lohner, Szimonetta; Mesotten, Dieter; Mihályi, Krisztina; Mihatsch, Walter A.; Mimouni, Francis; Mølgaard, Christian; Moltu, Sissel J.; Nomayo, Antonia; Picaud, Jean Charles; Prell, Christine; Puntis, John; Riskin, Arieh; Pipaón, Miguel Sáenz de; Senterre, Thibault; Shamir, Raanan; Simchowitz, Venetia; Szitányi, Peter; Tabbers, Merit M.; Akker, Chris H.B. Van Den; Goudoever, Johannes B. van; Kempen, Anne A. M. W. van; Verbruggen, Sascha; Wu, Jiang; Yan, Wei

doi:10.1016/j.clnu.2018.06.951

Cited by 84 publications

(86 citation statements)

References 108 publications

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“…The actual amount of vitamins/minerals delivered to the patient may therefore be lower than the intended dose. [32][33][34][35] There are different manufacturers of vitamins and mineral mixtures, and description depends on hospital/pharmacy protocols.…”

Section: Vitamins and Mineralsmentioning

confidence: 99%

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Optimal clinical management of children receiving ketogenic parenteral nutrition: a clinical practice guide

Louw

Aldaz

Harvey

et al. 2019

Develop Med Child Neuro

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AimTo give evidence‐based recommendations on the application of ketogenic diet parenteral nutrition (KD‐PN) in emergency situations.MethodAn international group of experts (n=14) researched the literature and distributed a survey among 150 expert centers. International accepted guidelines (European Society for Clinical Nutrition and Metabolism/European Society for Paediatric Gastroenterology Hepatology and Nutrition and the American Society for Parenteral and Enteral Nutrition) and handbooks for parenteral nutrition were considered general standards of care.ResultsIn the literature, we identified 35 reports of patients treated by KD‐PN. International guidelines and handbooks provided some conflicting information. Twenty‐four expert teams from nine countries responded to the survey, reflecting the limited clinical experience.InterpretationThis paper highlights 23 consensus‐based recommendations for safe and effective KD‐PN (e.g. diet initiation, calculation, application, monitoring, and evaluation) based on the best evidence available and expert opinions.What this paper adds In acute settings, ketogenic diet therapy (KDT) can be administered parenterally.Parenteral administration of KDT should be started only at the intensive care unit.Initiate ketogenic parenteral nutrition stepwise to the highest ratio possible with the lowest level of complications.Evaluate the risk–benefit ratio of parenteral administration continuously.Restart enteral feeding as soon as appropriate.

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Section: Vitamins and Mineralsmentioning

confidence: 99%

“…36 Other studies have provided supplementation according to international guidelines. 32,33 The White Paper on ketogenic diet gives no specific recommendations. 20 Results from our international survey showed 20 out of 24 centers added a multivitamin (Appendix S1).…”

Section: Vitamins and Mineralsmentioning

confidence: 99%

Optimal clinical management of children receiving ketogenic parenteral nutrition: a clinical practice guide

Louw

Aldaz

Harvey

et al. 2019

Develop Med Child Neuro

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“…Monitoring of water‐soluble vitamins is generally restricted to vitamin B12 and folate (using serum folate or red cell folate) as deficiencies and toxicities are rare . However, they are required daily, body stores being limited, except for B12 . Vitamin B12 requires close monitoring in children with ileal resection on partial PN.…”

Section: Long‐term Laboratory Monitoringmentioning

confidence: 99%

“…Serum methylmalonic acid and homocysteine are useful to confirm deficiency . In case of shortage of pediatric vitamin preparations, adult formulations should not be used as they can contain components associated with death in infants …”

Section: Long‐term Laboratory Monitoringmentioning

confidence: 99%

“…There is a wide variability in practices across IF centers in terms of monitoring these complex patients and limited data to guide the development of evidence‐based recommendations . Available guidelines include the joint guidelines from the European Society for Pediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) and the European Society of Parenteral and Enteral Nutrition (ESPEN) published in 2005 and updated in 2018 and the American Society for Parenteral and Enteral Nutrition recommendations published in 2017 …”

Section: Introductionmentioning

confidence: 99%

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Monitoring of long‐term parenteral nutrition in children with intestinal failure

Zemrani

Bines

2019

JGH Open

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Pediatric intestinal failure (IF) is a rare and complex condition associated with significant morbidity and mortality. It is defined as the reduction of gut mass or function below the minimal needed for absorption of nutrients and fluid to sustain life and growth. Since the advent of specialized multidisciplinary intestinal rehabilitation centers, IF management has considerably evolved in the last years, but serious complications of long‐term parenteral nutrition (PN) can occur. Main complications include intestinal failure‐associated liver disease, growth failure, body composition imbalance, central venous access complications, micronutrient deficiencies and toxicities, metabolic bone disease, small intestinal bacterial overgrowth, and renal disease. With improvement in survival rates of patients over the last 20 years, emphasis should be on limiting IF‐related comorbidities and improving quality of life. Close monitoring is pivotal to ensuring quality of care of these patients. The care of children with chronic IF should involve a comprehensive monitoring plan with flexibility for individualization according to specific patient needs. Monitoring of children on long‐term PN varies significantly across units and is mainly based on experience, although few guidelines exist. This narrative review summarizes the current knowledge and practices related to monitoring of children with IF. The authors also share their 20‐year experience at the Royal Children's Hospital in Melbourne Australia on this topic.

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Neonatal Refeeding Syndrome and Clinical Outcome in Extremely Low‐Birth‐Weight Babies: Secondary Cohort Analysis From the ProVIDe Trial

Cormack

Jiang

Harding

et al. 2020

J Parenter Enteral Nutr

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Background Refeeding syndrome (RS) following preterm birth has been linked to high intravenous (IV) protein intake in the presence of low electrolyte supply. In extremely low‐birth‐weight (ELBW) babies, we aimed to determine the incidence of RS and associations with birth characteristics and clinical outcomes. Method Prospective cohort study of ELBW ProVIDe Trial participants in 6 New Zealand neonatal intensive care units. RS was defined as serum phosphate < 1.4 mmol.L−1 and total calcium > 2.8 mmol.L−1. Relationships between RS and other factors were explored using 2‐sample tests and logistic regression adjusted for sex, gestation, and birth‐weight z‐score. Results Of 338 babies (mean [SD] birth‐weight, 780 (134) g, gestational age, 25.9 [1.7] weeks), 68 (20%) had RS. Mortality was greater in babies with RS (32% vs 11%; P < .0001). More small‐ than appropriate‐for‐gestational‐age babies developed RS (22% vs 8%; P = .001). Growth from birth to 36 weeks’ corrected age was not different between babies who did and did not have RS. In logistic regression, the odds of RS decreased by 70% for each 1 mmol per kg−1.d−1 IV phosphate intake (odds ratio [OR], 0.3; CI, 0.1–0.6; P = .002) and increased by 80% for each 1 g.kg−1.d−1 IV protein intake (OR, 1.8; CI, 1.3–2.7; P = .002). Conclusions Neonatal RS is common in this cohort of ELBW babies and is associated with increased morbidity and mortality. Optimizing phosphate and calcium intakes in IV nutrition solutions may reduce RS and its consequences.

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ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: Vitamins

Cited by 84 publications

References 108 publications

Optimal clinical management of children receiving ketogenic parenteral nutrition: a clinical practice guide

Optimal clinical management of children receiving ketogenic parenteral nutrition: a clinical practice guide

Monitoring of long‐term parenteral nutrition in children with intestinal failure

Neonatal Refeeding Syndrome and Clinical Outcome in Extremely Low‐Birth‐Weight Babies: Secondary Cohort Analysis From the ProVIDe Trial

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