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8. Correction: ESPNIC clinical practice guidelines: intravenous maintenance fluid therapy in acute and critically ill children— a systematic review and meta-analysis

Author

Brossier, David W., Tume, Lyvonne N., Briant, Anais R., Jotterand Chaparro, Corinne, Moullet, Clémence, Rooze, Shancy, Verbruggen, Sascha C. A. T., Marino, Luise V., Alsohime, Fahad, Beldjilali, Sophie, Chiusolo, Fabrizio, Costa, Leonardo, Didier, Capucine, Ilia, Stavroula, Joram, Nyandat L., Kneyber, Martin C. J., Kühlwein, Eva, Lopez, Jorge, López-Herce, Jesus, Mayberry, Huw F., Mehmeti, Fortesa, Mierzewska-Schmidt, Magdalena, Miñambres Rodríguez, Maria, Morice, Claire, Pappachan, John V., Porcheret, Florence, Reis Boto, Leonor, Schlapbach, Luregn J., Tekguc, Hakan, Tziouvas, Konstantinos, Parienti, Jean-Jacques, Goyer, Isabelle, and Valla, Frederic V.

Published
2023
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11. ESPNIC clinical practice guidelines: intravenous maintenance fluid therapy in acute and critically ill children- a systematic review and meta-analysis

Author

Brossier, David W., Tume, Lyvonne N., Briant, Anais R., Jotterand Chaparro, Corinne, Moullet, Clémence, Rooze, Shancy, and Verbruggen, Sascha C. A. T.

Subjects
Societies, Practice guidelines (Medicine), Children -- Health aspects, Medical colleges, Neonatology, Neonatal intensive care, Associations, institutions, etc., Health care industry
Abstract

Purpose Intravenous maintenance fluid therapy (IV-MFT) prescribing in acute and critically ill children is very variable among pediatric health care professionals. In order to provide up to date IV-MFT guidelines, the European Society of Pediatric and Neonatal Intensive Care (ESPNIC) undertook a systematic review to answer the following five main questions about IV-MFT: (i) the indications for use (ii) the role of isotonic fluid (iii) the role of balanced solutions (iv) IV fluid composition (calcium, magnesium, potassium, glucose and micronutrients) and v) and the optimal amount of fluid. Methods A multidisciplinary expert group within ESPNIC conducted this systematic review using the Scottish Intercollegiate Guidelines Network (SIGN) grading method. Five databases were searched for studies that answered these questions, in acute and critically children (from 37 weeks gestational age to 18 years), published until November 2020. The quality of evidence and risk of bias were assessed, and meta-analyses were undertaken when appropriate. A series of recommendations was derived and voted on by the expert group to achieve consensus through two voting rounds. Results 56 papers met the inclusion criteria, and 16 recommendations were produced. Outcome reporting was inconsistent among studies. Recommendations generated were based on a heterogeneous level of evidence, but consensus within the expert group was high. 'Strong consensus' was reached for 11/16 (69%) and 'consensus' for 5/16 (31%) of the recommendations. Conclusions Key recommendations are to use isotonic balanced solutions providing glucose to restrict IV-MFT infusion volumes in most hospitalized children and to regularly monitor plasma electrolyte levels, serum glucose and fluid balance., Author(s): David W. Brossier [sup.1], Lyvonne N. Tume [sup.2], Anais R. Briant [sup.3], Corinne Jotterand Chaparro [sup.4] [sup.5], Clémence Moullet [sup.4], Shancy Rooze [sup.6], Sascha C. A. T. Verbruggen [sup.7], [...]

Published
2022
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16. Leukocyte telomere length in paediatric critical illness: effect of early parenteral nutrition.

Author

Verstraete, Sören, Vanhorebeek, Ilse, van Puffelen, Esther, Derese, Inge, Ingels, Catherine, Verbruggen, Sascha, Wouters, Pieter, Joosten, Koen, Hanot, Jan, Guerra, Gonzalo, Vlasselaers, Dirk, Lin, Jue, and Van den Berghe, Greet

Subjects
Children, Critical care, Critical illness, Intensive care, Nutrition, PICU, Paediatric, Telomere length, Telomeres, Adolescent, Child, Child, Preschool, Critical Illness, Female, Humans, Infant, Intensive Care Units, Pediatric, Leukocytes, Male, Parenteral Nutrition, Pediatrics, Propensity Score, Survival Analysis, Telomere, Time Factors
Abstract

BACKGROUND: Children who have suffered from critical illnesses that required treatment in a paediatric intensive care unit (PICU) have long-term physical and neurodevelopmental impairments. The mechanisms underlying this legacy remain largely unknown. In patients suffering from chronic diseases hallmarked by inflammation and oxidative stress, poor long-term outcome has been associated with shorter telomeres. Shortened telomeres have also been reported to result from excessive food consumption and/or unhealthy nutrition. We investigated whether critically ill children admitted to the PICU have shorter-than-normal telomeres, and whether early parenteral nutrition (PN) independently affects telomere length when adjusting for known determinants of telomere length. METHODS: Telomere length was quantified in leukocyte DNA from 342 healthy children and from 1148 patients who had been enrolled in the multicenter, randomised controlled trial (RCT), PEPaNIC. These patients were randomly allocated to initiation of PN within 24 h (early PN) or to withholding PN for one week in PICU (late PN). The impact of early PN versus late PN on the change in telomere length from the first to last PICU-day was investigated with multivariable linear regression analyses. RESULTS: Leukocyte telomeres were 6% shorter than normal upon PICU admission (median 1.625 (IQR 1.446-1.825) telomere/single-copy-gene ratio (T/S) units vs. 1.727 (1.547-1.915) T/S-units in healthy children (P

Published
2018

19. Role of extracorporeal membrane oxygenation in pediatric cancer patients: a systematic review and meta-analysis of observational studies

Author

Slooff, Valerie, Hoogendoorn, Rianne, Nielsen, Jeppe Sylvest Angaard, Pappachan, John, Amigoni, Angela, Caramelli, Fabio, Aziz, Omer, Wildschut, Enno, Verbruggen, Sascha, Crazzolara, Roman, Dohna-Schwake, Christian, Potratz, Jenny, Willems, Jef, Llevadias, Judit, Moscatelli, Andrea, Montaguti, Alessia, Bottari, Gabriella, Di Nardo, Matteo, Schlapbach, Luregn, and Wösten-van Asperen, Roelie

Published
2022
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22. Effect of early parenteral nutrition during paediatric critical illness on DNA methylation as a potential mediator of impaired neurocognitive development: a pre-planned secondary analysis of the PEPaNIC international randomised controlled trial

Author

Güiza, Fabian, Vanhorebeek, Ilse, Verstraete, Sören, Verlinden, Ines, Derese, Inge, Ingels, Catherine, Dulfer, Karolijn, Verbruggen, Sascha C, Garcia Guerra, Gonzalo, Joosten, Koen F, Wouters, Pieter J, and Van den Berghe, Greet

Published
2020
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25. Call for sustainable food systems including (medical) nutrition for hospitalised children and their families

Author

Verbruggen, Sascha Cornelis Antonius Theodorus S.C.A.T., den Otter, Suzan Cochius, Bakker, Johanna, Briassoulis, George, Stavoula, Ilia, Latten, Lynne, Joosten, Koen, Rooze, Shancy, van Zanten, Eva, Beattie, Robert Mark, Marino, Luise Victoria, Verbruggen, Sascha Cornelis Antonius Theodorus S.C.A.T., den Otter, Suzan Cochius, Bakker, Johanna, Briassoulis, George, Stavoula, Ilia, Latten, Lynne, Joosten, Koen, Rooze, Shancy, van Zanten, Eva, Beattie, Robert Mark, and Marino, Luise Victoria

Abstract

The climate emergency presents a profound threat to global health, adversely affecting the health and well-being of children who are projected to bear a substantial disease burden, as well as impacting children's right to food, water, healthcare and education. The healthcare sector strives to prioritise preventative healthcare policies improving the health of individuals across the life course. However, current healthcare practices significantly contribute to greenhouse gas (GHG) emissions and waste generation, in which (medical) nutrition plays an important role. Plant-based proteins offer sustainability benefits, and potential health advantages, and have a lower climate footprint, although there may also be unintended consequences of land-use change and deforestation for certain crops. However, to develop suitable plant-based alternatives to medical nutrition, it will be necessary to address regulatory obstacles as well as ensure nutritional profiles are suitable, particularly protein (amino acid) and micronutrient composition. Additionally, the development of heat-tolerant and water-efficient plant genotypes could bolster adaptation to changing climatic conditions. Effective waste management, including wasted food and medical nutrition, emerges as a key strategy in mitigating the climate impact of medical nutrition. While research on food waste in healthcare settings is limited, minimising waste spillage in medical nutrition is a crucial area to explore. Healthcare professionals must acknowledge their roles in curbing the climate footprint of medical nutrition as well as recommendations for food-based approaches. This review aims to investigate the sustainability of medical nutrition for paediatric care, focusing on factors contributing to GHG emissions, plant-based alternatives, waste management and plastic packaging. Such an exploration is vital for healthcare professionals to fulfil their responsibilities in addressing the climate crisis while advocating for c, SCOPUS: re.j, info:eu-repo/semantics/published

Published
2024

26. 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

Author

Tume, Lyvonne N., Valla, Frederic V., Joosten, Koen, Jotterand Chaparro, Corinne, Latten, Lynne, Marino, Luise V., Macleod, Isobel, Moullet, Clémence, Pathan, Nazima, Rooze, Shancy, van Rosmalen, Joost, and Verbruggen, Sascha C. A. T.

Published
2020
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29. Long-term developmental effects of withholding parenteral nutrition for 1 week in the paediatric intensive care unit: a 2-year follow-up of the PEPaNIC international, randomised, controlled trial

Author

Verstraete, Sören, Verbruggen, Sascha C, Hordijk, José A, Vanhorebeek, Ilse, Dulfer, Karolijn, Güiza, Fabian, van Puffelen, Esther, Jacobs, An, Leys, Sandra, Durt, Astrid, Van Cleemput, Hanna, Eveleens, Renate D, Garcia Guerra, Gonzalo, Wouters, Pieter J, Joosten, Koen F, and Van den Berghe, Greet

Published
2019
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31. ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: Complications

Author

Braegger, Christian, Bronsky, Jiri, Cai, Wei, Campoy, Cristina, Carnielli, Virgilio, Darmaun, Dominique, Decsi, Tamás, Domellöf, Magnus, Embleton, Nicholas, Fewtrell, Mary, Fidler Mis, Nataša, Franz, Axel, Goulet, Olivier, Hartman, Corina, Hill, Susan, Hojsak, Iva, Iacobelli, Silvia, Jochum, Frank, Joosten, Koen, Kolaček, Sanja, Koletzko, Berthold, Ksiazyk, Janusz, Lapillonne, Alexandre, Lohner, Szimonetta, Mesotten, Dieter, Mihályi, Krisztina, Mihatsch, Walter A., Mimouni, Francis, Mølgaard, Christian, Moltu, Sissel J., Nomayo, Antonia, Picaud, Jean Charles, Prell, Christine, Puntis, John, Riskin, Arieh, Saenz De Pipaon, Miguel, Senterre, Thibault, Shamir, Raanan, Simchowitz, Venetia, Szitanyi, Peter, Tabbers, Merit M., Van Den Akker, Chris H.B., Van Goudoever, Johannes B., Van Kempen, Anne, Verbruggen, Sascha, Wu, Jiang, and Yan, Weihui

Published
2018
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32. ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: Fluid and electrolytes

Author

Braegger, Christian, Bronsky, Jiri, Cai, Wei, Campoy, Cristina, Carnielli, Virgilio, Darmaun, Dominique, Decsi, Tamás, Domellöf, Magnus, Embleton, Nicholas, Fewtrell, Mary, Fidler Mis, Nataša, Franz, Axel, Goulet, Olivier, Hartman, Corina, Hill, Susan, Hojsak, Iva, Iacobelli, Silvia, Jochum, Frank, Joosten, Koen, Kolaček, Sanja, Koletzko, Berthold, Ksiazyk, Janusz, Lapillonne, Alexandre, Lohner, Szimonetta, Mesotten, Dieter, Mihályi, Krisztina, Mihatsch, Walter A., Mimouni, Francis, Mølgaard, Christian, Moltu, Sissel J., Nomayo, Antonia, Picaud, Jean Charles, Prell, Christine, Puntis, John, Riskin, Arieh, Saenz De Pipaon, Miguel, Senterre, Thibault, Shamir, Raanan, Simchowitz, Venetia, Szitanyi, Peter, Tabbers, Merit M., Van Den Akker, Chris H.B., Van Goudoever, Johannes B., Van Kempen, Anne, Verbruggen, Sascha, Wu, Jiang, Yan, Weihui, Jochum, F., Moltu, S.J., Senterre, T., Nomayo, A., Goulet, O., and Iacobelli, S.

Published
2018
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33. ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: Organisational aspects

Author

Braegger, Christian, Bronsky, Jiri, Cai, Wei, Campoy, Cristina, Carnielli, Virgilio, Darmaun, Dominique, Decsi, Tamás, Domellöf, Magnus, Embleton, Nicholas, Fewtrell, Mary, Fidler Mis, Nataša, Franz, Axel, Goulet, Olivier, Hartman, Corina, Hill, Susan, Hojsak, Iva, Iacobelli, Silvia, Jochum, Frank, Joosten, Koen, Kolaček, Sanja, Koletzko, Berthold, Ksiazyk, Janusz, Lapillonne, Alexandre, Lohner, Szimonetta, Mesotten, Dieter, Mihályi, Krisztina, Mihatsch, Walter A., Mimouni, Francis, Mølgaard, Christian, Moltu, Sissel J., Nomayo, Antonia, Picaud, Jean Charles, Prell, Christine, Puntis, John, Riskin, Arieh, Saenz De Pipaon, Miguel, Senterre, Thibault, Shamir, Raanan, Simchowitz, Venetia, Szitanyi, Peter, Tabbers, Merit M., Van Den Akker, Chris H.B., Van Goudoever, Johannes B., Van Kempen, Anne, Verbruggen, Sascha, Wu, Jiang, Yan, Weihui, Puntis, JWL., Hojsak, I., and Ksiazyk, J.

Published
2018
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34. ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: Standard versus individualized parenteral nutrition

Author

Braegger, Christian, Bronsky, Jiri, Cai, Wei, Campoy, Cristina, Carnielli, Virgilio, Darmaun, Dominique, Decsi, Tamás, Domellöf, Magnus, Embleton, Nicholas, Fewtrell, Mary, Fidler Mis, Nataša, Franz, Axel, Goulet, Olivier, Hartman, Corina, Hill, Susan, Hojsak, Iva, Iacobelli, Silvia, Jochum, Frank, Joosten, Koen, Kolaček, Sanja, Koletzko, Berthold, Ksiazyk, Janusz, Lapillonne, Alexandre, Lohner, Szimonetta, Mesotten, Dieter, Mihályi, Krisztina, Mihatsch, Walter A., Mimouni, Francis, Mølgaard, Christian, Moltu, Sissel J., Nomayo, Antonia, Picaud, Jean Charles, Prell, Christine, Puntis, John, Riskin, Arieh, Saenz De Pipaon, Miguel, Senterre, Thibault, Shamir, Raanan, Simchowitz, Venetia, Szitanyi, Peter, Tabbers, Merit M., Van Den Akker, Chris H.B., Van Goudoever, Johannes B., Van Kempen, Anne, Verbruggen, Sascha, Wu, Jiang, Yan, Weihui, and Picaud, Jean-Charles

Published
2018
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35. ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: Venous access

Author

Braegger, Christian, Bronsky, Jiri, Cai, Wei, Campoy, Cristina, Carnielli, Virgilio, Darmaun, Dominique, Decsi, Tamás, Domellöf, Magnus, Embleton, Nicholas, Fewtrell, Mary, Fidler Mis, Nataša, Franz, Axel, Goulet, Olivier, Hartman, Corina, Hill, Susan, Hojsak, Iva, Iacobelli, Silvia, Jochum, Frank, Joosten, Koen, Kolaček, Sanja, Koletzko, Berthold, Ksiazyk, Janusz, Lapillonne, Alexandre, Lohner, Szimonetta, Mesotten, Dieter, Mihályi, Krisztina, Mihatsch, Walter A., Mimouni, Francis, Mølgaard, Christian, Moltu, Sissel J., Nomayo, Antonia, Picaud, Jean Charles, Prell, Christine, Puntis, John, Riskin, Arieh, Saenz De Pipaon, Miguel, Senterre, Thibault, Shamir, Raanan, Simchowitz, Venetia, Szitanyi, Peter, Tabbers, Merit M., Van Den Akker, Chris H.B., Van Goudoever, Johannes B., Van Kempen, Anne, Verbruggen, Sascha, Wu, Jiang, Yan, Weihui, Kolaček, S., Puntis, J.W.L., and Hojsak, I.

Published
2018
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36. ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: Home parenteral nutrition

Author

Braegger, Christian, Bronsky, Jiri, Cai, Wei, Campoy, Cristina, Carnielli, Virgilio, Darmaun, Dominique, Decsi, Tamás, Domellöf, Magnus, Embleton, Nicholas, Fewtrell, Mary, Fidler Mis, Nataša, Franz, Axel, Goulet, Olivier, Hartman, Corina, Hill, Susan, Hojsak, Iva, Iacobelli, Silvia, Jochum, Frank, Joosten, Koen, Kolaček, Sanja, Koletzko, Berthold, Ksiazyk, Janusz, Lapillonne, Alexandre, Lohner, Szimonetta, Mesotten, Dieter, Mihályi, Krisztina, Mihatsch, Walter A., Mimouni, Francis, Mølgaard, Christian, Moltu, Sissel J., Nomayo, Antonia, Picaud, Jean Charles, Prell, Christine, Puntis, John, Riskin, Arieh, Saenz De Pipaon, Miguel, Senterre, Thibault, Shamir, Raanan, Simchowitz, Venetia, Szitanyi, Peter, Tabbers, Merit M., Van Den Akker, Chris H.B., Van Goudoever, Johannes B., Van Kempen, Anne, Verbruggen, Sascha, Wu, Jiang, Yan, Weihui, and Tabbers, Merit

Published
2018
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37. ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: Lipids

Author

Braegger, Christian, Bronsky, Jiri, Cai, Wei, Campoy, Cristina, Carnielli, Virgilio, Darmaun, Dominique, Decsi, Tamás, Domellöf, Magnus, Embleton, Nicholas, Fewtrell, Mary, Fidler Mis, Nataša, Franz, Axel, Goulet, Olivier, Hartman, Corina, Hill, Susan, Hojsak, Iva, Iacobelli, Silvia, Jochum, Frank, Joosten, Koen, Kolaček, Sanja, Koletzko, Berthold, Ksiazyk, Janusz, Lapillonne, Alexandre, Lohner, Szimonetta, Mesotten, Dieter, Mihályi, Krisztina, Mihatsch, Walter A., Mimouni, Francis, Mølgaard, Christian, Moltu, Sissel J., Nomayo, Antonia, Picaud, Jean Charles, Prell, Christine, Puntis, John, Riskin, Arieh, Saenz De Pipaon, Miguel, Senterre, Thibault, Shamir, Raanan, Simchowitz, Venetia, Szitanyi, Peter, Tabbers, Merit M., Van Den Akker, Chris H.B., Van Goudoever, Johannes B., Van Kempen, Anne, Verbruggen, Sascha, Wu, Jiang, Yan, Weihui, van den Akker, Chris H.P., and Wu, Jennifer

Published
2018
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38. ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: Guideline development process for the updated guidelines

Author

Braegger, Christian, Bronsky, Jiri, Cai, Wei, Campoy, Cristina, Carnielli, Virgilio, Darmaun, Dominique, Decsi, Tamás, Domellöf, Magnus, Embleton, Nicholas, Fewtrell, Mary, Fidler Mis, Nataša, Franz, Axel, Goulet, Olivier, Hartman, Corina, Hill, Susan, Hojsak, Iva, Iacobelli, Silvia, Jochum, Frank, Joosten, Koen, Kolaček, Sanja, Koletzko, Berthold, Ksiazyk, Janusz, Lapillonne, Alexandre, Lohner, Szimonetta, Mesotten, Dieter, Mihályi, Krisztina, Mihatsch, Walter A., Mimouni, Francis, Mølgaard, Christian, Moltu, Sissel J., Nomayo, Antonia, Picaud, Jean Charles, Prell, Christine, Puntis, John, Riskin, Arieh, Saenz De Pipaon, Miguel, Senterre, Thibault, Shamir, Raanan, Simchowitz, Venetia, Szitanyi, Peter, Tabbers, Merit M., Dirk, Vlasselaers, Van Den Akker, Chris H.B., Van Goudoever, Johannes B., Van Kempen, Anne, Verbruggen, Sascha, Wu, Jiang, Yan, Weihui, Mihatsch, W., Shamir, R., van Goudoever, J.B., Fewtrell, M., Lapillonne, A., Lohner, S., Mihályi, K., and Decsi, T.

Published
2018
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39. ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: Amino acids

Author

Braegger, Christian, Bronsky, Jiri, Cai, Wei, Campoy, Cristina, Carnielli, Virgilio, Darmaun, Dominique, Decsi, Tamás, Domellöf, Magnus, Embleton, Nicholas, Fewtrell, Mary, Fidler Mis, Nataša, Franz, Axel, Goulet, Olivier, Hartman, Corina, Hill, Susan, Hojsak, Iva, Iacobelli, Silvia, Jochum, Frank, Joosten, Koen, Kolaček, Sanja, Koletzko, Berthold, Ksiazyk, Janusz, Lapillonne, Alexandre, Lohner, Szimonetta, Mesotten, Dieter, Mihályi, Krisztina, Mihatsch, Walter A., Mimouni, Francis, Mølgaard, Christian, Moltu, Sissel J., Nomayo, Antonia, Picaud, Jean Charles, Prell, Christine, Puntis, John, Riskin, Arieh, Saenz De Pipaon, Miguel, Senterre, Thibault, Shamir, Raanan, Simchowitz, Venetia, Szitanyi, Peter, Tabbers, Merit M., Van Den Akker, Chris H.B., Van Goudoever, Johannes B., Van Kempen, Anne, Verbruggen, Sascha, Wu, Jiang, Yan, Weihui, van Goudoever, Johannes B., and Sainz de Pipaon, Miguel

Published
2018
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40. ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: Energy

Author

Braegger, Christian, Bronsky, Jiri, Cai, Wei, Campoy, Cristina, Carnielli, Virgilio, Darmaun, Dominique, Decsi, Tamás, Domellöf, Magnus, Embleton, Nicholas, Fewtrell, Mary, Fidler Mis, Nataša, Franz, Axel, Goulet, Olivier, Hartman, Corina, Hill, Susan, Hojsak, Iva, Iacobelli, Silvia, Jochum, Frank, Joosten, Koen, Kolaček, Sanja, Koletzko, Berthold, Ksiazyk, Janusz, Lapillonne, Alexandre, Lohner, Szimonetta, Mesotten, Dieter, Mihályi, Krisztina, Mihatsch, Walter A., Mimouni, Francis, Mølgaard, Christian, Moltu, Sissel J., Nomayo, Antonia, Picaud, Jean Charles, Prell, Christine, Puntis, John, Riskin, Arieh, Saenz De Pipaon, Miguel, Senterre, Thibault, Shamir, Raanan, Simchowitz, Venetia, Szitanyi, Peter, Tabbers, Merit M., Van Den Akker, Chris H.B., Van Goudoever, Johannes B., Van Kempen, Anne, Verbruggen, Sascha, Wu, Jiang, Yan, Weihui, Joosten, K., Embleton, N., Yan, W., and Senterre, T.

Published
2018
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41. ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: Iron and trace minerals

Author

Braegger, Christian, Bronsky, Jiri, Cai, Wei, Campoy, Cristina, Carnielli, Virgilio, Darmaun, Dominique, Decsi, Tamás, Domellöf, Magnus, Embleton, Nicholas, Fewtrell, Mary, Fidler Mis, Nataša, Franz, Axel, Goulet, Olivier, Hartman, Corina, Hill, Susan, Hojsak, Iva, Iacobelli, Silvia, Jochum, Frank, Joosten, Koen, Kolaček, Sanja, Koletzko, Berthold, Ksiazyk, Janusz, Lapillonne, Alexandre, Lohner, Szimonetta, Mesotten, Dieter, Mihályi, Krisztina, Mihatsch, Walter A., Mimouni, Francis, Mølgaard, Christian, Moltu, Sissel J., Nomayo, Antonia, Picaud, Jean Charles, Prell, Christine, Puntis, John, Riskin, Arieh, Saenz De Pipaon, Miguel, Senterre, Thibault, Shamir, Raanan, Simchowitz, Venetia, Szitanyi, Peter, Tabbers, Merit M., Van Den Akker, Chris H.B., Van Goudoever, Johannes B., Van Kempen, Anne, Verbruggen, Sascha, Wu, Jiang, Yan, Weihui, Domellöf, M., Szitanyi, P., Simchowitz, V., Franz, A., and Mimouni, F.

Published
2018
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43. Dynamics and prognostic value of the hypothalamus-pituitary-adrenal axis responses to pediatric critical illness and association with corticosteroid treatment: a prospective observational study

Author

Jacobs, An, Derese, Inge, Vander Perre, Sarah, Wouters, Pieter J., Verbruggen, Sascha, Billen, Jaak, and Vermeersch, Pieter

Subjects
Children -- Diseases, Medical research -- Analysis -- Physiological aspects -- Health aspects, Medicine, Experimental -- Analysis -- Physiological aspects -- Health aspects, Pediatrics -- Health aspects -- Physiological aspects -- Analysis, Corticosteroids -- Health aspects -- Physiological aspects -- Analysis, Protein binding -- Physiological aspects -- Health aspects -- Analysis, Ethylenediaminetetraacetic acid -- Physiological aspects -- Analysis -- Health aspects, Proteins -- Health aspects -- Analysis -- Physiological aspects, ACTH -- Physiological aspects -- Analysis -- Health aspects, Health care industry
Abstract

Purpose Increased systemic cortisol availability during adult critical illness is determined by reduced binding-proteins and suppressed breakdown rather than elevated ACTH. Dynamics, drivers and prognostic value of hypercortisolism during pediatric critical illness remain scarcely investigated. Methods This preplanned secondary analysis of the PEPaNIC-RCT (N = 1440), after excluding 420 children treated with corticosteroids before PICU-admission, documented (a) plasma ACTH, (free)cortisol and cortisol-metabolism at PICU-admission, day-3 and last PICU-day, their prognostic value, and impact of withholding early parenteral nutrition (PN), (b) the association between corticosteroid-treatment and these hormones, and (c) the association between corticosteroid-treatment and outcome. Results ACTH was normal upon PICU-admission and low thereafter (p [less than or equal to] 0.0004). Total and free cortisol were only elevated upon PICU-admission (p [less than or equal to] 0.0003) and thereafter became normal despite low binding-proteins (p < 0.0001) and persistently suppressed cortisol-metabolism (p [less than or equal to] 0.03). Withholding early-PN did not affect this phenotype. On PICU-day-3, high free cortisol and low ACTH independently predicted worse outcome (p [less than or equal to] 0.003). Also, corticosteroid-treatment initiated in PICU, which further suppressed ACTH (p < 0.0001), was independently associated with poor outcomes (earlier live PICU-discharge: p < 0.0001, 90-day mortality: p = 0.02). Conclusion In critically ill children, systemic cortisol availability is elevated only transiently, much lower than in adults, and not driven by elevated ACTH. Further ACTH lowering by corticosteroid-treatment indicates active feedback inhibition at pituitary level. Beyond PICU-admission-day, low ACTH and high cortisol, and corticosteroid-treatment, predicted poor outcome. This suggests that exogenously increasing cortisol availability during acute critical illness in children may be inappropriate. Future studies on corticosteroid-treatment in critically ill children should plan safety analyses, as harm may be possible., Author(s): An Jacobs [sup.1], Inge Derese [sup.1], Sarah Vander Perre [sup.1], Pieter J. Wouters [sup.1], Sascha Verbruggen [sup.2], Jaak Billen [sup.3], Pieter Vermeersch [sup.3], Gonzalo Garcia Guerra [sup.4], Koen Joosten [...]

Published
2020
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44. THU155 Aberrant DNA Methylation Within Genes Of The HPA-axis Two Years After Paediatric Critical Illness, Role Of Glucocorticoid Treatment And Association With Impaired Physical And Neurocognitive Development.

Author

Coppens, Gregoire, primary, Vanhorebeek, Ilse, additional, Guïza, Fabian, additional, Derese, Inge, additional, Wouters, Pieter J, additional, Koen, Joosten F, additional, Verbruggen, Sascha C, additional, and Van den Berghe, Greet, additional

Published
2023
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45. Gastrointestinal biomarkers and their association with feeding in the first five days of pediatric critical illness

Author

Veldscholte, Karlien, primary, Hulst, Jessie M., additional, Eveleens, Renate D., additional, de Jonge, Rogier C.J., additional, de Koning, Barbara A.E., additional, van den Berg, Sjoerd A.A., additional, van der Wal, Ronald, additional, Ruijter, George J.G., additional, Rizopoulos, Dimitris, additional, Vanhorebeek, Ilse, additional, Gunst, Jan, additional, Casaer, Michaël, additional, Van den Berghe, Greet, additional, Joosten, Koen F.M., additional, and Verbruggen, Sascha C.A.T., additional

Published
2023
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