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Optimal nutrition therapy in paediatric critical care in the Asia-Pacific and Middle East: a consensus.
Asia Pac J Clin Nutr 2016; 25(4):676-696AP

Abstract

BACKGROUND AND OBJECTIVES

Current practices and available resources for nutrition therapy in paediatric intensive care units (PICUs) in the Asia Pacific-Middle East region are expected to differ from western countries. Existing guidelines for nutrition management in critically ill children may not be directly applicable in this region. This paper outlines consensus statements developed by the Asia Pacific-Middle East Consensus Working Group on Nutrition Therapy in the Paediatric Critical Care Environment. Challenges and recommendations unique to the region are described.

METHODS AND STUDY DESIGN

Following a systematic literature search from 2004-2014, consensus statements were developed for key areas of nutrient delivery in the PICU. This review focused on evidence applicable to the Asia Pacific-Middle East region. Quality of evidence and strength of recommendations were rated according to the Grading of Recommendation Assessment, Development and Evaluation approach.

RESULTS

Enteral nutrition (EN) is the preferred mode of nutritional support. Feeding algorithms that optimize EN should be encouraged and must include: assessment and monitoring of nutritional status, selection of feeding route, time to initiate and advance EN, management strategies for EN intolerance and indications for using parenteral nutrition (PN). Despite heterogeneity in nutritional status of patients, availability of resources and diversity of cultures, PICUs in the region should consider involvement of dieticians and/or nutritional support teams.

CONCLUSIONS

Robust evidence for several aspects of optimal nutrition therapy in PICUs is lacking. Nutritional assessment must be implemented to document prevalence and impact of malnutrition. Nutritional support must be given greater priority in PICUs, with particular emphasis in optimizing EN delivery.

Authors+Show Affiliations

Children's Intensive Care Unit, KK Women's and Children's Hospital, and Office of Clinical Sciences, Duke-NUS School of Medicine, Singapore. Email: lee.jan.hau@singhealth.com.sg.Department of Nutrition and Food Services, Royal Children's Hospital, Melbourne, Australia.Sarawak General Hospital, Malaysia.Division of Paediatric Pulmonary and Critical Care, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.Paediatric Critical Care and Paediatric Haematology- Oncology Divisions of Department of Paediatrics, Khoo Teck Puat- National University Children's Medical Institute, National University Hospital, Singapore.Paediatric Gastroenterology, Hepatology and Nutrition, Sheikh Khalifa Medical City, United Arab Emirates.Paediatric Gastroenterology and Nutrition, Department of Paediatrics, King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia.Paediatric Critical Care Division, Department of Child Health, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia.Department of Paediatrics, Advanced Paediatrics Center, Postgraduate Institute of Medical Education and Research, India.Division of Critical Care Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital Boston, United States.

Pub Type(s)

Consensus Development Conference
Journal Article
Review

Language

eng

PubMed ID

27702711

Citation

Lee, Jan Hau, et al. "Optimal Nutrition Therapy in Paediatric Critical Care in the Asia-Pacific and Middle East: a Consensus." Asia Pacific Journal of Clinical Nutrition, vol. 25, no. 4, 2016, pp. 676-696.
Lee JH, Rogers E, Chor YK, et al. Optimal nutrition therapy in paediatric critical care in the Asia-Pacific and Middle East: a consensus. Asia Pac J Clin Nutr. 2016;25(4):676-696.
Lee, J. H., Rogers, E., Chor, Y. K., Samransamruajkit, R., Koh, P. L., Miqdady, M., ... Mehta, N. M. (2016). Optimal nutrition therapy in paediatric critical care in the Asia-Pacific and Middle East: a consensus. Asia Pacific Journal of Clinical Nutrition, 25(4), pp. 676-696. doi:10.6133/apjcn.012016.07.
Lee JH, et al. Optimal Nutrition Therapy in Paediatric Critical Care in the Asia-Pacific and Middle East: a Consensus. Asia Pac J Clin Nutr. 2016;25(4):676-696. PubMed PMID: 27702711.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Optimal nutrition therapy in paediatric critical care in the Asia-Pacific and Middle East: a consensus. AU - Lee,Jan Hau, AU - Rogers,Elizabeth, AU - Chor,Yek Kee, AU - Samransamruajkit,Rujipat, AU - Koh,Pei Lin, AU - Miqdady,Mohamad, AU - Al-Mehaidib,Ali Ibrahim, AU - Pudjiadi,Antonius, AU - Singhi,Sunit, AU - Mehta,Nilesh M, PY - 2016/10/6/entrez PY - 2016/10/6/pubmed PY - 2017/1/14/medline SP - 676 EP - 696 JF - Asia Pacific journal of clinical nutrition JO - Asia Pac J Clin Nutr VL - 25 IS - 4 N2 - BACKGROUND AND OBJECTIVES: Current practices and available resources for nutrition therapy in paediatric intensive care units (PICUs) in the Asia Pacific-Middle East region are expected to differ from western countries. Existing guidelines for nutrition management in critically ill children may not be directly applicable in this region. This paper outlines consensus statements developed by the Asia Pacific-Middle East Consensus Working Group on Nutrition Therapy in the Paediatric Critical Care Environment. Challenges and recommendations unique to the region are described. METHODS AND STUDY DESIGN: Following a systematic literature search from 2004-2014, consensus statements were developed for key areas of nutrient delivery in the PICU. This review focused on evidence applicable to the Asia Pacific-Middle East region. Quality of evidence and strength of recommendations were rated according to the Grading of Recommendation Assessment, Development and Evaluation approach. RESULTS: Enteral nutrition (EN) is the preferred mode of nutritional support. Feeding algorithms that optimize EN should be encouraged and must include: assessment and monitoring of nutritional status, selection of feeding route, time to initiate and advance EN, management strategies for EN intolerance and indications for using parenteral nutrition (PN). Despite heterogeneity in nutritional status of patients, availability of resources and diversity of cultures, PICUs in the region should consider involvement of dieticians and/or nutritional support teams. CONCLUSIONS: Robust evidence for several aspects of optimal nutrition therapy in PICUs is lacking. Nutritional assessment must be implemented to document prevalence and impact of malnutrition. Nutritional support must be given greater priority in PICUs, with particular emphasis in optimizing EN delivery. SN - 0964-7058 UR - https://www.unboundmedicine.com/medline/citation/27702711/Optimal_nutrition_therapy_in_paediatric_critical_care_in_the_Asia_Pacific_and_Middle_East:_a_consensus_ L2 - http://apjcn.nhri.org.tw/server/APJCN/25/4/676.pdf DB - PRIME DP - Unbound Medicine ER -