Akron Nephrology Associates/Cleveland Clinic Akron General Medical Center, Akron, Ohio.
Akron Children's Hospital, Akron, Ohio.
Kidney360. 2024 Feb 1;5(2):285-309. doi: 10.34067/KID.0000000000000339. Epub 2023 Dec 19.
Nutrition plays a vital role in the outcome of critically ill children, particularly those with AKI. Currently, there are no established guidelines for children with AKI treated with continuous RRT (CRRT). A thorough understanding of the metabolic changes and nutritional challenges in AKI and CRRT is required. Our objective was to create clinical practice points for nutritional assessment and management in critically ill children with AKI receiving CRRT.
PubMed, MEDLINE, Cochrane, and Embase databases were searched for articles related to the topic. Expertise of the authors and a consensus of the workgroup were additional sources of data in the article. Available articles on nutrition therapy in pediatric patients receiving CRRT through January 2023.
On the basis of the literature review, the current evidence base was examined by a panel of experts in pediatric nephrology and nutrition. The panel used the literature review as well as their expertise to formulate clinical practice points. The modified Delphi method was used to identify and refine clinical practice points.
Forty-four clinical practice points are provided on nutrition assessment, determining energy needs, and nutrient intake in children with AKI and on CRRT on the basis of the existing literature and expert opinions of a multidisciplinary panel.
营养在危重症患儿的预后中起着至关重要的作用，尤其是那些患有急性肾损伤（AKI）的患儿。目前，对于接受连续肾脏替代治疗（CRRT）的 AKI 患儿，尚无既定的指南。因此，需要深入了解 AKI 和 CRRT 中的代谢变化和营养挑战。我们的目的是为接受 CRRT 的 AKI 危重症患儿制定营养评估和管理的临床实践要点。
检索了与该主题相关的 PubMed、MEDLINE、Cochrane 和 Embase 数据库中的文章。作者的专业知识和工作组的共识是本文的其他数据来源。检索了截至 2023 年 1 月接受 CRRT 的儿科患者营养治疗的可用文章。
根据文献复习，由儿科肾脏病学和营养专家组成的专家组对现有证据基础进行了检查。专家组利用文献综述和专业知识制定了临床实践要点。采用改良 Delphi 法确定和完善临床实践要点。
根据现有文献和多学科专家组的专家意见，提供了 44 条关于 AKI 患儿的营养评估、确定能量需求和营养素摄入以及 CRRT 的临床实践要点。
