PMID- 30352749
OWN - NLM
STAT- MEDLINE
DCOM- 20200925
LR  - 20200925
IS  - 1532-1983 (Electronic)
IS  - 0261-5614 (Linking)
VI  - 38
IP  - 5
DP  - 2019 Oct
TI  - Association between enteral macronutrient delivery and inflammatory response in 
      critically ill children.
PG  - 2287-2296
LID - S0261-5614(18)32471-3 [pii]
LID - 10.1016/j.clnu.2018.10.001 [doi]
AB  - BACKGROUND AND AIMS: An important goal of nutrition support in paediatric 
      critical illness is minimising catabolism. While focussing on providing full 
      energy requirements, macronutrient balance is often neglected. Studies suggest 
      that there is interplay between nutrition and inflammation. We aimed to assess 
      the amount of enteral macronutrients delivered compared to estimated 
      requirements, and the association between delivered macronutrients and systemic 
      inflammation in critically ill children. METHOD: We prospectively evaluated 
      energy and macronutrient intake in critically ill children who required at least 
      72 h of mechanical ventilation. Data on enteral energy and macronutrient intake 
      was collected and expressed as a percentage of the estimated requirements. 
      Circulating levels of inflammatory cytokines were measured by ELISA and 
      association assessed with delivery of macronutrients from the previous 24 h. 
      RESULTS: A total of 87 children (0-16 years) were included in this study. By day 
      3 the median (IQR) intake of energy, fat, carbohydrate (CHO) and protein were 75% 
      (50-103), 85% (43-120), 63% (42-102) and 45% (23-65) respectively. We have also 
      shown that delivery of enteral fat and protein was associated with elevation in 
      the levels of tumour necrosis factor alpha (TNF-alpha) and interleukin-6 (IL-6). 
      CONCLUSION: The inflammatory response in critically ill children is influenced by 
      the amount of enteral fat and protein delivered. Our data suggests that within 
      the feed delivered, fat is often higher than protein and CHO. It is crucial to 
      take into account the proportion of macronutrients required and not only aim to 
      achieve the energy goal.
CI  - Crown Copyright (c) 2018. Published by Elsevier Ltd. All rights reserved.
FAU - Zaher, Sara
AU  - Zaher S
AD  - Department of Paediatrics, University of Cambridge, Hills Road, Cambridge, CB2 
      0QQ, UK; Clinical Nutrition Department, Faculty of Applied Medical Sciences, 
      Taibah University, Saudi Arabia. Electronic address: Sz332@cam.ac.uk.
FAU - White, Deborah
AU  - White D
AD  - Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 
      0QQ, UK.
FAU - Ridout, Jenna
AU  - Ridout J
AD  - Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 
      0QQ, UK.
FAU - Valla, Frederic
AU  - Valla F
AD  - Hospices Civils de Lyon, Paediatric Intensive Care, Hopital Femme Mere Enfant, 59 
      bd Pinel, Lyon-Bron, FR 69500, France.
FAU - Branco, Ricardo
AU  - Branco R
AD  - Department of Paediatrics, University of Cambridge, Hills Road, Cambridge, CB2 
      0QQ, UK; Cambridge University Hospitals NHS Foundation Trust, Hills Road, 
      Cambridge, CB2 0QQ, UK.
FAU - Meyer, Rosan
AU  - Meyer R
AD  - Imperial College London, Kensington, London, SW7 2AZ, UK.
FAU - Pathan, Nazima
AU  - Pathan N
AD  - Department of Paediatrics, University of Cambridge, Hills Road, Cambridge, CB2 
      0QQ, UK; Cambridge University Hospitals NHS Foundation Trust, Hills Road, 
      Cambridge, CB2 0QQ, UK.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20181011
PL  - England
TA  - Clin Nutr
JT  - Clinical nutrition (Edinburgh, Scotland)
JID - 8309603
RN  - 0 (Cytokines)
RN  - 0 (Dietary Carbohydrates)
RN  - 0 (Dietary Fats)
SB  - IM
MH  - Adolescent
MH  - Child
MH  - Child, Preschool
MH  - *Critical Illness/epidemiology/therapy
MH  - Cytokines/blood
MH  - Dietary Carbohydrates/administration & dosage
MH  - Dietary Fats/administration & dosage
MH  - *Enteral Nutrition/adverse effects/methods/statistics & numerical data
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - *Inflammation/epidemiology/metabolism
MH  - Nutrients/administration & dosage
MH  - Prospective Studies
MH  - Respiration, Artificial
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Critical illness
OT  - Cytokines
OT  - Enteral feeding
OT  - Macronutrients
OT  - Malnutrition
OT  - Underfeeding
EDAT- 2018/10/26 06:00
MHDA- 2020/09/26 06:00
CRDT- 2018/10/25 06:00
PHST- 2018/04/27 00:00 [received]
PHST- 2018/09/17 00:00 [revised]
PHST- 2018/10/02 00:00 [accepted]
PHST- 2018/10/26 06:00 [pubmed]
PHST- 2020/09/26 06:00 [medline]
PHST- 2018/10/25 06:00 [entrez]
AID - S0261-5614(18)32471-3 [pii]
AID - 10.1016/j.clnu.2018.10.001 [doi]
PST - ppublish
SO  - Clin Nutr. 2019 Oct;38(5):2287-2296. doi: 10.1016/j.clnu.2018.10.001. Epub 2018 
      Oct 11.