Early versus late parenteral nutrition in critically ill children-PEPaNIC. Verbruggen S. 2016. abstract bibtex In critically ill children, the impact of early parenteral nutrition on clinical outcomes is unclear. In adults, recent trials have questioned the benefit of early parenteral nutrition. This multi-center randomized controlled trial of 1440 critically ill children investigated whether withholding parenteral nutrition for 1 week (late parenteral nutrition) in the pediatric intensive care unit (PICU), while providing similar fluid loading, is clinically superior to early parenteral nutrition. In 723 patients in the early parenteral nutrition group, parenteral nutrition was initiated within 24 hours, whereas the 717 patients in the late parenteral nutrition group did not receive parenteral nutrition before day 8. In both groups, enteral nutrition was attempted early, and intravenous micronutrients were given. Whereas mortality rates were similar, late parenteral nutrition reduced the proportion of patients with a new infection from 18.5% with early parenteral nutrition to 10.7% [Adjusted Odds Ratio 0.48 (95%CI 0.35-0.66)]. Late parenteral nutrition also reduced the duration of PICU stay from a mean+/-SEM 9.2+/-0.8 days to 6.5+/-0.4 days, with a higher likelihood of an earlier live discharge from PICU at any time [Adjusted Hazard Ratio 1.23 (1.11-1.37)]. Late parenteral nutrition reduced the duration of mechanical ventilatory support (P=0.001), the proportion of patients on renal replacement therapy (P=0.038) and the duration of hospital stay (P=0.001). Late parenteral nutrition lowered plasma gamma-glutamyltransferase (P=0.001) and alkaline-phosphatase (P=0.036) concentrations and increased plasma bilirubin (P=0.004) and C-reactive-protein (P=0.006). In critically ill children, omitting parenteral nutrition for 1 week was clinically superior to providing early parenteral nutrition.
@misc{verbruggen_s._early_2016,
title = {Early versus late parenteral nutrition in critically ill children-{PEPaNIC}},
abstract = {In critically ill children, the impact of early parenteral nutrition on clinical outcomes is unclear. In adults, recent trials have questioned the benefit of early parenteral nutrition. This multi-center randomized controlled trial of 1440 critically ill children investigated whether withholding parenteral nutrition for 1 week (late parenteral nutrition) in the pediatric intensive care unit (PICU), while providing similar fluid loading, is clinically superior to early parenteral nutrition. In 723 patients in the early parenteral nutrition group, parenteral nutrition was initiated within 24 hours, whereas the 717 patients in the late parenteral nutrition group did not receive parenteral nutrition before day 8. In both groups, enteral nutrition was attempted early, and intravenous micronutrients were given. Whereas mortality rates were similar, late parenteral nutrition reduced the proportion of patients with a new infection from 18.5\% with early parenteral nutrition to 10.7\% [Adjusted Odds Ratio 0.48 (95\%CI 0.35-0.66)]. Late parenteral nutrition also reduced the duration of PICU stay from a mean+/-SEM 9.2+/-0.8 days to 6.5+/-0.4 days, with a higher likelihood of an earlier live discharge from PICU at any time [Adjusted Hazard Ratio 1.23 (1.11-1.37)]. Late parenteral nutrition reduced the duration of mechanical ventilatory support (P=0.001), the proportion of patients on renal replacement therapy (P=0.038) and the duration of hospital stay (P=0.001). Late parenteral nutrition lowered plasma gamma-glutamyltransferase (P=0.001) and alkaline-phosphatase (P=0.036) concentrations and increased plasma bilirubin (P=0.004) and C-reactive-protein (P=0.006). In critically ill children, omitting parenteral nutrition for 1 week was clinically superior to providing early parenteral nutrition.},
journal = {European Journal of Pediatrics},
author = {{Verbruggen S.}},
year = {2016},
keywords = {*critically ill patient, *parenteral nutrition, Child, alkaline phosphatase, artificial ventilation, bilirubin blood level, controlled clinical trial, controlled study, endogenous compound, enteric feeding, gamma glutamyltransferase, gene inactivation, hazard ratio, hospitalization, human, human tissue, infection, major clinical study, mortality rate, odds ratio, pediatric intensive care unit, randomized controlled trial, renal replacement therapy, trace element}
}
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{"_id":"vcemiJJAaxbCrSYJc","bibbaseid":"verbruggens-earlyversuslateparenteralnutritionincriticallyillchildrenpepanic-2016","downloads":0,"creationDate":"2017-05-12T20:20:57.522Z","title":"Early versus late parenteral nutrition in critically ill children-PEPaNIC","author_short":["Verbruggen S."],"year":2016,"bibtype":"misc","biburl":"http://bibbase.org/zotero/gxu917","bibdata":{"bibtype":"misc","type":"misc","title":"Early versus late parenteral nutrition in critically ill children-PEPaNIC","abstract":"In critically ill children, the impact of early parenteral nutrition on clinical outcomes is unclear. In adults, recent trials have questioned the benefit of early parenteral nutrition. This multi-center randomized controlled trial of 1440 critically ill children investigated whether withholding parenteral nutrition for 1 week (late parenteral nutrition) in the pediatric intensive care unit (PICU), while providing similar fluid loading, is clinically superior to early parenteral nutrition. In 723 patients in the early parenteral nutrition group, parenteral nutrition was initiated within 24 hours, whereas the 717 patients in the late parenteral nutrition group did not receive parenteral nutrition before day 8. In both groups, enteral nutrition was attempted early, and intravenous micronutrients were given. Whereas mortality rates were similar, late parenteral nutrition reduced the proportion of patients with a new infection from 18.5% with early parenteral nutrition to 10.7% [Adjusted Odds Ratio 0.48 (95%CI 0.35-0.66)]. Late parenteral nutrition also reduced the duration of PICU stay from a mean+/-SEM 9.2+/-0.8 days to 6.5+/-0.4 days, with a higher likelihood of an earlier live discharge from PICU at any time [Adjusted Hazard Ratio 1.23 (1.11-1.37)]. Late parenteral nutrition reduced the duration of mechanical ventilatory support (P=0.001), the proportion of patients on renal replacement therapy (P=0.038) and the duration of hospital stay (P=0.001). Late parenteral nutrition lowered plasma gamma-glutamyltransferase (P=0.001) and alkaline-phosphatase (P=0.036) concentrations and increased plasma bilirubin (P=0.004) and C-reactive-protein (P=0.006). In critically ill children, omitting parenteral nutrition for 1 week was clinically superior to providing early parenteral nutrition.","journal":"European Journal of Pediatrics","author":[{"firstnames":[],"propositions":[],"lastnames":["Verbruggen S."],"suffixes":[]}],"year":"2016","keywords":"*critically ill patient, *parenteral nutrition, Child, alkaline phosphatase, artificial ventilation, bilirubin blood level, controlled clinical trial, controlled study, endogenous compound, enteric feeding, gamma glutamyltransferase, gene inactivation, hazard ratio, hospitalization, human, human tissue, infection, major clinical study, mortality rate, odds ratio, pediatric intensive care unit, randomized controlled trial, renal replacement therapy, trace element","bibtex":"@misc{verbruggen_s._early_2016,\n\ttitle = {Early versus late parenteral nutrition in critically ill children-{PEPaNIC}},\n\tabstract = {In critically ill children, the impact of early parenteral nutrition on clinical outcomes is unclear. In adults, recent trials have questioned the benefit of early parenteral nutrition. This multi-center randomized controlled trial of 1440 critically ill children investigated whether withholding parenteral nutrition for 1 week (late parenteral nutrition) in the pediatric intensive care unit (PICU), while providing similar fluid loading, is clinically superior to early parenteral nutrition. In 723 patients in the early parenteral nutrition group, parenteral nutrition was initiated within 24 hours, whereas the 717 patients in the late parenteral nutrition group did not receive parenteral nutrition before day 8. In both groups, enteral nutrition was attempted early, and intravenous micronutrients were given. Whereas mortality rates were similar, late parenteral nutrition reduced the proportion of patients with a new infection from 18.5\\% with early parenteral nutrition to 10.7\\% [Adjusted Odds Ratio 0.48 (95\\%CI 0.35-0.66)]. Late parenteral nutrition also reduced the duration of PICU stay from a mean+/-SEM 9.2+/-0.8 days to 6.5+/-0.4 days, with a higher likelihood of an earlier live discharge from PICU at any time [Adjusted Hazard Ratio 1.23 (1.11-1.37)]. Late parenteral nutrition reduced the duration of mechanical ventilatory support (P=0.001), the proportion of patients on renal replacement therapy (P=0.038) and the duration of hospital stay (P=0.001). Late parenteral nutrition lowered plasma gamma-glutamyltransferase (P=0.001) and alkaline-phosphatase (P=0.036) concentrations and increased plasma bilirubin (P=0.004) and C-reactive-protein (P=0.006). 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