Optimal nutrition therapy in paediatric critical care in the Asia-Pacific and Middle East: A consensus

Jan Hau Lee, Elizabeth Rogers, Yek Kee Chor, Rujipat Samransamruajkit, Pei Lin Koh, Mohamad Miqdady, Ali Ibrahim Al-Mehaidib, Antonius H. Pudjiadi, Sunit Singhi, Nilesh M. Mehta

Research output: Contribution to journalReview articlepeer-review

14 Citations (Scopus)

Abstract

Background and Objectives: Current practices and available resources for nutrition therapy in paediatric intensive care units (PICUs) in the Asia Pacific-Middle East region are expected to differ from western countries. Existing guidelines for nutrition management in critically ill children may not be directly applicable in this region. This paper outlines consensus statements developed by the Asia Pacific-Middle East Consensus Working Group on Nutrition Therapy in the Paediatric Critical Care Environment. Challenges and recommendations unique to the region are described. Methods and Study Design: Following a systematic literature search from 2004-2014, consensus statements were developed for key areas of nutrient delivery in the PICU. This review focused on evidence applicable to the Asia Pacific-Middle East region. Quality of evidence and strength of recommendations were rated according to the Grading of Recommendation Assessment, Development and Evaluation approach. Results: Enteral nutrition (EN) is the preferred mode of nutritional support. Feeding algorithms that optimize EN should be encouraged and must include: assessment and monitoring of nutritional status, selection of feeding route, time to initiate and advance EN, management strategies for EN intolerance and indications for using parenteral nutrition (PN). Despite heterogeneity in nutritional status of patients, availability of resources and diversity of cultures, PICUs in the region should consider involvement of dieticians and/or nutritional support teams. Conclusions: Robust evidence for several aspects of optimal nutrition therapy in PICUs is lacking. Nutritional assessment must be implemented to document prevalence and impact of malnutrition. Nutritional support must be given greater priority in PICUs, with particular emphasis in optimizing EN delivery.

Original languageEnglish
Pages (from-to)676-696
Number of pages21
JournalAsia Pacific journal of clinical nutrition
Volume25
Issue number4
DOIs
Publication statusPublished - 2016

Keywords

  • Asia Pacific
  • Children
  • Critical care
  • Middle East
  • Nutrition

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