Pediatric International Nutrition Study 2018
| Status: | Enrolling by invitation |
|---|---|
| Conditions: | Hospital |
| Therapuetic Areas: | Other |
| Healthy: | No |
| Age Range: | Any - 18 |
| Updated: | 10/3/2018 |
| Start Date: | January 10, 2018 |
| End Date: | March 31, 2019 |
Pediatric International Nutrition Study - a Prospective, Multicenter Cohort Study of Nutritional Practices and Outcomes in Pediatric Intensive Care Units Around the World
This is a multi-site study of how nutrition is delivered to critically ill patients in
pediatric intensive care units (PICUs) around the world. Each site will include mechanically
ventilated children in their respective PICUs and record the details of what type and amount
of nutrition was received. These details will be compared to goals designated by the
clinicians caring for each patient. Data will be entered in a secure online remote data
capture tool and managed by the lead researchers in Pediatric Critical Care Nutrition at
Boston Children's Hospital, Nilesh Mehta, MD and Lori Bechard, PhD, RD. Data will be analyzed
to better understand how different types and amounts of nutrition impact important PICU
outcomes such as length of stay, ventilator time, incidence of infections, and mortality.
pediatric intensive care units (PICUs) around the world. Each site will include mechanically
ventilated children in their respective PICUs and record the details of what type and amount
of nutrition was received. These details will be compared to goals designated by the
clinicians caring for each patient. Data will be entered in a secure online remote data
capture tool and managed by the lead researchers in Pediatric Critical Care Nutrition at
Boston Children's Hospital, Nilesh Mehta, MD and Lori Bechard, PhD, RD. Data will be analyzed
to better understand how different types and amounts of nutrition impact important PICU
outcomes such as length of stay, ventilator time, incidence of infections, and mortality.
Specific aim 1: To examine the impact of energy and protein adequacy on clinical outcomes.
Specific aim 2: To describe world-wide patterns of nutritional therapies in the
PICU.environment: use of guidelines/use of adjuncts (acid suppression, motility,
etc.)/glycemic control strategy/etc. To describe these practices in subgroups of: cardiac,
surgical, medical, oncology/stem cell transplant patients in the PICU.
Specific aim 3: To examine enteral nutrition practices, including timing, route (gastric vs.
post pyloric), adjuncts, and enteral nutrition (EN) intolerance definitions, in PICU patients
worldwide Specific aim 4: To examine the current practices around parenteral nutrition
prescription during the first week of critical illness in the PICU; time of initiation (early
vs. late), rationale, threshold for initiation.
Primary predictor: nutritional adequacy (energy, protein) Secondary predictors: nutritional
status, use of guidelines/site level indicators (location, staffing), use of adjuncts (acid
suppression, motility, etc.), EN intolerance, subgroups (cardiac, surgical, medical,
oncology/stem cell transplant), EN route/timing
Specific aim 2: To describe world-wide patterns of nutritional therapies in the
PICU.environment: use of guidelines/use of adjuncts (acid suppression, motility,
etc.)/glycemic control strategy/etc. To describe these practices in subgroups of: cardiac,
surgical, medical, oncology/stem cell transplant patients in the PICU.
Specific aim 3: To examine enteral nutrition practices, including timing, route (gastric vs.
post pyloric), adjuncts, and enteral nutrition (EN) intolerance definitions, in PICU patients
worldwide Specific aim 4: To examine the current practices around parenteral nutrition
prescription during the first week of critical illness in the PICU; time of initiation (early
vs. late), rationale, threshold for initiation.
Primary predictor: nutritional adequacy (energy, protein) Secondary predictors: nutritional
status, use of guidelines/site level indicators (location, staffing), use of adjuncts (acid
suppression, motility, etc.), EN intolerance, subgroups (cardiac, surgical, medical,
oncology/stem cell transplant), EN route/timing
Inclusion Criteria:
- Sites with at least 8 PICU beds with the capacity to designate a site-specific
clinician for data collection, preferably a clinician with an interest in nutrition or
a dietitian, are eligible to participate.
- Patients 1 month to 18 years of age, admitted to the PICU and requiring mechanical
ventilation with an anticipated length of PICU stay of 3 days or more.
Exclusion Criteria:
- Sites with < 8 PICU beds and/or no available clinician for data collection
- Subjects < 1 month or > 18 years, PICU length of stay < 3 days, not mechanically
ventilated, receiving compassionate care only towards end of life, or enrolled in a
nutrition intervention trial
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Boston Children's Hospital Boston Children's Hospital is a 395-bed comprehensive center for pediatric health care....
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