Safety and Tolerability of Enteral Protein Supplementation for Infants With Brain Injury

Merhar, Stephanie L.; Meinzen‐Derr, Jareen; Sprague, Jennifer; Wessel, Jacqueline; Leugers, Staci; Painter, Jessica; Valentine, Christina J.

doi:10.1177/0884533614567715

Cited by 6 publications

(9 citation statements)

References 29 publications

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“…Out of the 27 studies selected for full-text reading, 19 studies were excluded, four because they are study projects/protocols already included in their final published version or study projects with no results and 15 because they are observational studies. Resulting in eight included studies for this review [ 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 ], with six studies exploring CP and two of them exploring TBI in children ( Figure 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…This systematic review included studies published between 2000 and 2018, including the following countries: Japan [ 11 ], Italy [ 12 ], United States of America [ 13 , 18 ], United Kingdom [ 14 , 16 ], Australia [ 15 ], and Greece [ 17 ]. Most of the studies were carried out in hospitals or children’s centers.…”

Section: Resultsmentioning

confidence: 99%

“…The age of the study participants ranged from 1 month to 15 years old, including female and male children, with a larger male population. Considering nutrition, five studies [ 11 , 13 , 15 , 17 , 18 ] presented enteral route of food administration, one study [ 16 ] presented oral and enteral, and two other studies [ 12 , 14 ] presented only oral nutrition. The interventions sought to evaluate results in the improvement of gastrointestinal symptoms such as reflux, constipation, gastric emptying, weight gain, neurological growth, and development.…”

Section: Resultsmentioning

confidence: 99%

“…Regarding randomization process (Domain 1): The studies [ 12 , 14 , 15 , 18 ] reported being randomized, but they did not explain how the randomization and allocation of patients was carried out, being classified as “Some concerns”—some doubts regarding this stage of the research. The other studies [ 11 , 13 , 16 , 17 ] were classified as low risk of bias because they described the randomization process in detail. Deviations from the intended intervention (Domain 2): all included studies described how the intervention was prescribed in detail, including blinding, as a result, the domain was classified as low risk of bias.…”

Section: Resultsmentioning

confidence: 99%

“…Missing outcome data (Domain 3): all included studies described the results from the participants randomized, including data on research objectives, as a result the domain was classified as low risk of bias. Measurement of outcome (Domain 4): all included studies used adequate methods for measuring the outcomes and the assessments did not differ from experimental and control groups [ 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 ], as a result the domain was classified as low risk of bias. Selection of the reported result (Domain 5): all included studies were registered at ClinicalTrials.gov.…”

Section: Resultsmentioning

confidence: 99%

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Nutritional Interventions in Children with Brain Injuries: A Systematic Review

et al. 2021

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Background: Brain injury has several consequences throughout life, its increased incidence has caused great public concern. The aim was identifying the main nutritional therapies recommended for children with brain injuries. Methods: A systematic review was carried out using the terms in the search strategy: “Brain Injuries”, “Nutrition Therapy”, and “Child” and their synonyms, from database inception up to August 2020. The search was conducted in the following databases: MEDLINE, EMBASE, Scopus, Cochrane library, LILACS, and grey literature. Two reviewers independently selected the included studies, according to the eligibility criteria and extracted data from the included articles. Results: A total of 1196 studies resulted from electronic searches, and out of these, 27 studies were read in full and eight studies were included. For early enteral nutritional support (<48 h), results suggest benefit in increasing survival rates. Type of dietary protein seems to be related to decreasing gastric emptying by 40%. The use of fibers seems to reduce gastrointestinal discomfort and increase stool frequency. Conclusions: The evidence mapped was extracted from small studies analyzing different outcomes, so any decision making should be analyzed considering the context. We present the direction of the effect, but the magnitude is still unclear.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Nutritional Interventions in Children with Brain Injuries: A Systematic Review

et al. 2021

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Nutritional support for children during critical illness: European Society of Pediatric and Neonatal Intensive Care (ESPNIC) metabolism, endocrine and nutrition section position statement and clinical recommendations

et al. 2020

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Background: Nutritional support is considered essential for the outcome of paediatric critical illness. There is a lack of methodologically sound trials to provide evidence-based guidelines leading to diverse practices in PICUs worldwide. Acknowledging these limitations, we aimed to summarize the available literature and provide practical guidance for the paediatric critical care clinicians around important clinical questions many of which are not covered by previous guidelines. Objective:To provide an ESPNIC position statement and make clinical recommendations for the assessment and nutritional support in critically ill infants and children. Design: The metabolism, endocrine and nutrition (MEN) section of the European Society of Pediatric and NeonatalIntensive Care (ESPNIC) generated 15 clinical questions regarding different aspects of nutrition in critically ill children. After a systematic literature search, the Scottish Intercollegiate Guidelines Network (SIGN) grading system was applied to assess the quality of the evidence, conducting meta-analyses where possible, to generate statements and clinical recommendations, which were then voted on electronically. Strong consensus (> 95% agreement) and consensus (> 75% agreement) on these statements and recommendations was measured through modified Delphi voting rounds. Results:The final 15 clinical questions generated a total of 7261 abstracts, of which 142 publications were identified relevant to develop 32 recommendations. A strong consensus was reached in 21 (66%) and consensus was reached in 11 (34%) of the recommendations. Only 11 meta-analyses could be performed on 5 questions. Conclusions:We present a position statement and clinical practice recommendations. The general level of evidence of the available literature was low. We have summarised this and provided a practical guidance for the paediatric critical care clinicians around important clinical questions.There is a lack of high-quality evidence to guide nutrition in paediatric critical illness. This position statement and clinical recommendations summarise the existing evidence around 15 of the most important clinical questions, and where no evidence is available, suggest good clinical practice.

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Nutrition and the developing brain

Valentine

2019

Pediatr Res

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Safety and Tolerability of Enteral Protein Supplementation for Infants With Brain Injury

Abstract: These results suggest that enteral protein supplementation may reduce growth failure in infants with brain injury.

Cited by 6 publications

References 29 publications

Nutritional Interventions in Children with Brain Injuries: A Systematic Review

Nutritional Interventions in Children with Brain Injuries: A Systematic Review

Nutritional support for children during critical illness: European Society of Pediatric and Neonatal Intensive Care (ESPNIC) metabolism, endocrine and nutrition section position statement and clinical recommendations

Nutrition and the developing brain

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