Faculty of Health & Applied Sciences, University of the West of England, Bristol, UK.
Pediatric Intensive Care Unit, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Lyon-Bron, France.
JPEN J Parenter Enteral Nutr. 2019 Sep;43(7):853-862. doi: 10.1002/jpen.1498. Epub 2018 Dec 26.
Widespread variation exists in pediatric critical care nutrition practices, largely because of the scarcity of evidence to guide best practice recommendations.
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.
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.
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.
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.
儿科重症监护营养实践存在广泛的差异，主要是因为缺乏证据来指导最佳实践建议。
本文的目的是确定儿科重症监护营养领域未来 10 年需要优先研究的营养研究课题清单。
一个由 11 名从事儿科重症监护营养领域的国际研究人员组成的新的多学科小组采用改良的 3 轮 Delphi 法。项目按 5 分制李克特量表进行评分。
在以下 10 个领域内确定了 45 个研究课题（平均优先得分>3（0-5））：危重病中营养不良的病理生理学和影响；营养评估：营养风险评估和生物标志物；准确评估所有危重病阶段的能量需求；蛋白质摄入的作用；药物营养的作用；肠内营养的有效和安全输送；肠内喂养不耐受：评估和管理；肠外营养的作用；营养状况和营养治疗对长期患者结局的影响；以及特定人群的营养治疗。10 个最重要的研究课题（平均得分为>4（0-5））被确定为儿科重症监护营养研究的最高优先事项。
本文确定了儿科重症监护营养临床研究的重要共识优先事项。未来的研究应该确定患者和家长认为优先的课题。研究资金应针对这些优先领域，并促进该领域的国际合作研究方法，重点是改善相关患者结局。
