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Review of Outcomes Used in Nutrition Trials in Pediatric Critical Care

Kunal R Gadhvi1,2, Frédéric V Valla2,3, Lyvonne N Tume1,2

  • 1Bristol Royal Hospital for Children, Bristol, UK.

JPEN. Journal of Parenteral and Enteral Nutrition
|February 4, 2020
PubMed

Insights

Pediatric intensive care (PIC) nutrition trials show wide variation in outcome measures and definitions. Standardizing key nutrition and non-nutrition outcomes is crucial for future research and evidence generation in PIC settings.

Area of Science:

  • Pediatric Intensive Care
  • Clinical Nutrition Research
  • Evidence-Based Medicine

Background:

  • Generating robust evidence in pediatric intensive care (PIC) is challenging due to small patient numbers and heterogeneity.
  • Systematic reviews face limitations from non-standardized outcome measures and definitions.
  • The increasing number of nutrition intervention trials in PIC necessitates an examination of current outcome measures.

Purpose of the Study:

  • To systematically describe the outcome measures utilized in randomized controlled trials evaluating nutrition interventions in PIC.
  • To identify variations and inconsistencies in outcome reporting within this field.

Main Methods:

  • A systematic literature review was conducted for PIC nutrition intervention trials published between January 1, 1996, and February 20, 2018.
  • Twenty-nine trials, involving 3226 patients, were analyzed.

Main Results:

  • A total of 37 primary and 83 secondary outcomes were identified, categorized into PIC-related (infection, dependency, organ dysfunction, mortality) and nutrition-specific outcomes (energy targets, nutrition parameters, feeding tolerance).
  • Significant variation was observed in the chosen outcome measures.
  • Key outcome domains, including energy targets, feeding tolerance, and infection, lacked adequate definition.

Conclusions:

  • Considerable variation in outcome measures and definitions exists in PIC nutrition trials.
  • There is a need to establish consensus on optimal nutrition outcomes, including nutrition efficiency, tolerance, and relevant non-nutrition PIC outcomes.
  • The next step involves an international Delphi study to develop a core outcome set for future pediatric nutrition trials.
Abstract

Keywords:
childcore outcome setpediatric critical care nutritionpediatric intensive care

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