Corinne Jotterand Chaparro1, Jocelyne Laure Depeyre2, David Longchamp3, Marie-Hélène Perez4, Patrick Taffé5, Jacques Cotting6. 1. Department of Nutrition and Dietetics, School of Health Professions, University of Applied Sciences Western Switzerland (HES-SO), Rue des Caroubiers 25, 1227 Carouge, Geneva, Switzerland. Electronic address: corinne.jotterand@hesge.ch. 2. Department of Nutrition and Dietetics, School of Health Professions, University of Applied Sciences Western Switzerland (HES-SO), Rue des Caroubiers 25, 1227 Carouge, Geneva, Switzerland. Electronic address: jocelyne.depeyre@hesge.ch. 3. Paediatric Intensive Care Unit, Medico-Surgical Department of Paediatrics, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland. Electronic address: david.longchamp@chuv.ch. 4. Paediatric Intensive Care Unit, Medico-Surgical Department of Paediatrics, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland. Electronic address: marie-helene.perez@chuv.ch. 5. Institute for Social and Preventive Medicine (IUMSP), Biopôle 2, Route de la Corniche 10, 1010 Lausanne, Switzerland. Electronic address: patrick.taffe@chuv.ch. 6. Paediatric Intensive Care Unit, Medico-Surgical Department of Paediatrics, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland. Electronic address: jacques.cotting@chuv.ch.
Abstract
BACKGROUND & AIMS: Protein and energy requirements in critically ill children are currently based on insufficient data. Moreover, longitudinal measurements of both total urinary nitrogen (TUN) and resting energy expenditure (REE) are lacking. The aim of this study was to investigate how much protein and energy are needed to equilibrate nitrogen and energy balances in ventilated critically ill children on the basis of daily measurements of TUN, REE and protein and energy intakes. Comparisons were made with the guidelines of the American Society for Parenteral and Enteral Nutrition and the Dietary Reference Intakes. METHODS: Children with an expected duration of mechanical ventilation ≥72 h were prospectively recruited. TUN was measured by chemiluminescence, and REE was measured by indirect calorimetry. Generalised linear models for longitudinal data were used to study the relation between protein intake and nitrogen balance and to calculate the minimum intake of protein needed to achieve nitrogen equilibrium. A similar approach was used for energy. Results were compared to the recommended values. RESULTS: Based on 402 measurements performed in 74 children (median age: 21 months), the mean TUN was high at 0.20 (95% CI: 0.20, 0.22) g/kg/d and the REE was 55 (95% CI: 54, 57) kcal/kg/d. Nitrogen and energy balances were achieved with 1.5 (95% CI: 1.4, 1.6) g/kg/d of protein and 58 (95% CI: 53, 63) kcal/kg/d for the entire group, but there were differences among children of different ages. Children required more protein and less energy than the Dietary Reference Intakes. CONCLUSIONS: In critically ill children, TUN was elevated and REE was reduced during the entire period of mechanical ventilation. Minimum intakes of 1.5 g/kg/d of protein and 58 kcal/kg/d can equilibrate nitrogen and energy balances in children up to 4 years old. Older children require more protein.
BACKGROUND & AIMS: Protein and energy requirements in critically ill children are currently based on insufficient data. Moreover, longitudinal measurements of both total urinary nitrogen (TUN) and resting energy expenditure (REE) are lacking. The aim of this study was to investigate how much protein and energy are needed to equilibrate nitrogen and energy balances in ventilated critically ill children on the basis of daily measurements of TUN, REE and protein and energy intakes. Comparisons were made with the guidelines of the American Society for Parenteral and Enteral Nutrition and the Dietary Reference Intakes. METHODS:Children with an expected duration of mechanical ventilation ≥72 h were prospectively recruited. TUN was measured by chemiluminescence, and REE was measured by indirect calorimetry. Generalised linear models for longitudinal data were used to study the relation between protein intake and nitrogen balance and to calculate the minimum intake of protein needed to achieve nitrogen equilibrium. A similar approach was used for energy. Results were compared to the recommended values. RESULTS: Based on 402 measurements performed in 74 children (median age: 21 months), the mean TUN was high at 0.20 (95% CI: 0.20, 0.22) g/kg/d and the REE was 55 (95% CI: 54, 57) kcal/kg/d. Nitrogen and energy balances were achieved with 1.5 (95% CI: 1.4, 1.6) g/kg/d of protein and 58 (95% CI: 53, 63) kcal/kg/d for the entire group, but there were differences among children of different ages. Children required more protein and less energy than the Dietary Reference Intakes. CONCLUSIONS: In critically ill children, TUN was elevated and REE was reduced during the entire period of mechanical ventilation. Minimum intakes of 1.5 g/kg/d of protein and 58 kcal/kg/d can equilibrate nitrogen and energy balances in children up to 4 years old. Older children require more protein.
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: Xian-Jie Huang; Fei-Fei Guo; Fan Li; Jian-Chuang Zhao; Ya-Zhen Fan; Na Wang; Jun-Ying Qiao Journal: Zhongguo Dang Dai Er Ke Za Zhi Date: 2020-11
Authors: J L Rosterman; E K Pallotto; W E Truog; H Escobar; K A Meinert; A Holmes; H Dai; W M Manimtim Journal: J Perinatol Date: 2017-10-26 Impact factor: 2.521
Authors: Judith Ju Ming Wong; Jacqueline Soo May Ong; Chengsi Ong; John Carsen Allen; Mihir Gandhi; Lijia Fan; Ryan Taylor; Joel Kian Boon Lim; Pei Fen Poh; Fang Kuan Chiou; Jan Hau Lee Journal: BMJ Open Date: 2022-01-04 Impact factor: 2.692