OBJECTIVE: To compare a standard diet and a protein-enriched diet in critically ill children. STUDY DESIGN: In this prospective randomized controlled trial in critically ill children, all patients receivedenteral nutrition exclusively and were randomly assigned to a standard diet or a protein-enriched diet (1.1 g protein/100 mL of feeding formula). Blood and urine tests, nitrogen balance assessment, and energy expenditure testing by indirect calorimetry were performed before the beginning of the nutrition regimen and at 24 hours, 72 hours, and 5 days after initiation. Demographic data and pediatric mortality risk scores were recorded. RESULTS:Fifty-one children were randomized, and 41 completed the study. Of these, 21 patients receivedstandard formula and 20 received a protein-enriched formula. There were no between-group differences in terms age, sex, diagnosis, or mortality risk scores. There was a greater positive trend in levels of prealbumin, transferrin, retinol-binding protein, and total protein in the protein-enriched diet group. These differences were significant only for retinol-binding protein. The positive nitrogen balance trend was also higher in the protein-enriched diet group; however, this difference did not reach statistical significance. No adverse effects or hyperproteinemia were detected in the protein-enriched diet group. CONCLUSIONS: The standard diet provides insufficient protein delivery to critically ill children. Enteral protein supplementation is safe and can improve some biochemical parameters of protein metabolism.
RCT Entities:
OBJECTIVE: To compare a standard diet and a protein-enriched diet in critically ill children. STUDY DESIGN: In this prospective randomized controlled trial in critically ill children, all patients received enteral nutrition exclusively and were randomly assigned to a standard diet or a protein-enriched diet (1.1 g protein/100 mL of feeding formula). Blood and urine tests, nitrogen balance assessment, and energy expenditure testing by indirect calorimetry were performed before the beginning of the nutrition regimen and at 24 hours, 72 hours, and 5 days after initiation. Demographic data and pediatric mortality risk scores were recorded. RESULTS: Fifty-one children were randomized, and 41 completed the study. Of these, 21 patients received standard formula and 20 received a protein-enriched formula. There were no between-group differences in terms age, sex, diagnosis, or mortality risk scores. There was a greater positive trend in levels of prealbumin, transferrin, retinol-binding protein, and total protein in the protein-enriched diet group. These differences were significant only for retinol-binding protein. The positive nitrogen balance trend was also higher in the protein-enriched diet group; however, this difference did not reach statistical significance. No adverse effects or hyperproteinemia were detected in the protein-enriched diet group. CONCLUSIONS: The standard diet provides insufficient protein delivery to critically ill children. Enteral protein supplementation is safe and can improve some biochemical parameters of protein metabolism.
Authors: Allan Doctor; Jerry Zimmerman; Michael Agus; Surender Rajasekaran; Juliane Bubeck Wardenburg; James Fortenberry; Anne Zajicek; Emma Mairson; Katri Typpo Journal: Pediatr Crit Care Med Date: 2017-03 Impact factor: 3.624
Authors: Lyvonne N Tume; Frederic V Valla; Koen Joosten; Corinne Jotterand Chaparro; Lynne Latten; Luise V Marino; Isobel Macleod; Clémence Moullet; Nazima Pathan; Shancy Rooze; Joost van Rosmalen; Sascha C A T Verbruggen Journal: Intensive Care Med Date: 2020-02-20 Impact factor: 17.440
Authors: Nilesh M Mehta; Lori J Bechard; Naomi Cahill; Miao Wang; Andrew Day; Christopher P Duggan; Daren K Heyland Journal: Crit Care Med Date: 2012-07 Impact factor: 7.598