Lyvonne N Tume1, Frédéric V Valla2, Alejandro A Floh3,4, Praveen Goday5, Corinne Jotterand Chaparro6,7, Bodil Larsen8, Jan Hau Lee9,10, Yara M F Moreno11, Nazima Pathan12, Sascha Verbruggen13, Nilesh M Mehta14. 1. Faculty of Health & Applied Sciences, University of the West of England, Bristol, UK. 2. Pediatric Intensive Care Unit, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Lyon-Bron, France. 3. Department of Pediatrics, University of Toronto, Toronto, Canada. 4. Cardiac Critical Care Unit, Department of Critical Care, The Hospital for Sick Children, Toronto, Canada. 5. Pediatric Gastroenterology, Nutrition Medical College of Wisconsin, Milwaukee, Wisconsin, USA. 6. Department of Nutrition and Dietetics, University of Applied Sciences Western Switzerland (HES-SO), Geneva, Switzerland. 7. Pediatric Intensive Care Unit, Medico-Surgical Department of Pediatrics, University Hospital of Lausanne, Lausanne, Switzerland. 8. Department of ALES (Human Nutrition), University of Alberta, Edmonton, Canada. 9. Children's Intensive Care Unit, KK Women's and Children's Hospital, Singapore, Singapore. 10. Duke-NUS Medical School, Singapore, Singapore. 11. Department of Nutrition and Postgraduate Program in Nutrition, Santa Catarina Federal University, Health Sciences Centre, Florianópolis, Santa Catarina, Brazil. 12. Addenbrooke's Hospital, University of Cambridge, Cambridge, England. 13. Pediatric Intensive Care Unit, Erasmus MC - Sophia Children's Hospital, Rotterdam, the Netherlands. 14. Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Abstract
BACKGROUND: Widespread variation exists in pediatric critical care nutrition practices, largely because of the scarcity of evidence to guide best practice recommendations. OBJECTIVE: The objective of this paper was to develop a list of topics to be prioritized for nutrition research in pediatric critical care in the next 10 years. METHODS: A modified 3-round Delphi process was undertaken by a newly established multidisciplinary group comprising 11 international researchers in the field of pediatric critical care nutrition. Items were ranked on a 5-point Likert scale. RESULTS: Forty-five research topics (with a mean priority score >3(0-5) were identified within the following 10 domains: the pathophysiology and impact of malnutrition in critical illness; nutrition assessment: nutrition risk assessment and biomarkers; accurate assessment of energy requirements in all phases of critical illness; the role of protein intake; the role of pharmaco-nutrition; effective and safe delivery of enteral nutrition; enteral feeding intolerance: assessment and management; the role of parenteral nutrition; the impact of nutrition status and nutrition therapies on long-term patient outcomes; and nutrition therapies for specific populations. Ten top research topics (that received a mean score >4(0-5) were identified as the highest priority for research. CONCLUSIONS: This paper has identified important consensus-derived priorities for clinical research in pediatric critical care nutrition. Future studies should determine topics that are a priority for patients and parents. Research funding should target these priority areas and promote an international collaborative approach to research in this field, with a focus on improving relevant patient outcomes.
BACKGROUND: Widespread variation exists in pediatric critical care nutrition practices, largely because of the scarcity of evidence to guide best practice recommendations. OBJECTIVE: The objective of this paper was to develop a list of topics to be prioritized for nutrition research in pediatric critical care in the next 10 years. METHODS: A modified 3-round Delphi process was undertaken by a newly established multidisciplinary group comprising 11 international researchers in the field of pediatric critical care nutrition. Items were ranked on a 5-point Likert scale. RESULTS: Forty-five research topics (with a mean priority score >3(0-5) were identified within the following 10 domains: the pathophysiology and impact of malnutrition in critical illness; nutrition assessment: nutrition risk assessment and biomarkers; accurate assessment of energy requirements in all phases of critical illness; the role of protein intake; the role of pharmaco-nutrition; effective and safe delivery of enteral nutrition; enteral feeding intolerance: assessment and management; the role of parenteral nutrition; the impact of nutrition status and nutrition therapies on long-term patient outcomes; and nutrition therapies for specific populations. Ten top research topics (that received a mean score >4(0-5) were identified as the highest priority for research. CONCLUSIONS: This paper has identified important consensus-derived priorities for clinical research in pediatric critical care nutrition. Future studies should determine topics that are a priority for patients and parents. Research funding should target these priority areas and promote an international collaborative approach to research in this field, with a focus on improving relevant patient outcomes.
Authors: Graeme O'Connor; Luise V Marino; Lyvonne N Tume; Alexandra Stewart; Simon Gates; Julie Lanigan; Harish Bangalore; Suzannah Kinsella Journal: Crit Care Explor Date: 2022-03-04