Priorities for Nutrition Research in Pediatric Critical Care

JPEN J Parenter Enteral Nutr. 2019 Sep;43(7):853-862. doi: 10.1002/jpen.1498. Epub 2018 Dec 26.

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.

Keywords: child; children; enteral nutrition; intensive care; parenteral nutrition.

MeSH terms

  • Child
  • Child Nutrition Disorders / prevention & control
  • Child Nutrition Disorders / therapy*
  • Child Nutritional Physiological Phenomena*
  • Consensus
  • Critical Care / methods*
  • Critical Illness
  • Delphi Technique
  • Humans
  • Intensive Care Units, Pediatric*
  • Internationality
  • Nutritional Support / methods*
  • Research*