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dc.contributor.authorZaher, Saraen
dc.contributor.authorWhite, Deborahen
dc.contributor.authorRidout, Jennaen
dc.contributor.authorValla, Fredericen
dc.contributor.authorBranco, Ricardoen
dc.contributor.authorMeyer, Rosanen
dc.contributor.authorPathan, Nazimaen
dc.date.accessioned2018-12-05T00:30:50Z
dc.date.available2018-12-05T00:30:50Z
dc.date.issued2019-10en
dc.identifier.issn0261-5614
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/286314
dc.description.abstractAbstract: Background and aims: An important goal of nutrition support in paediatric critical illness is minimising catabolism. While focusing 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 hours 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 hours. 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-α) 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.
dc.description.sponsorshipEvelyn Trust
dc.format.mediumPrint-Electronicen
dc.languageengen
dc.publisherElsevier
dc.subjectHumansen
dc.subjectCritical Illnessen
dc.subjectInflammationen
dc.subjectDietary Carbohydratesen
dc.subjectDietary Fatsen
dc.subjectCytokinesen
dc.subjectTreatment Outcomeen
dc.subjectRespiration, Artificialen
dc.subjectEnteral Nutritionen
dc.subjectProspective Studiesen
dc.subjectAdolescenten
dc.subjectChilden
dc.subjectChild, Preschoolen
dc.subjectInfanten
dc.subjectInfant, Newbornen
dc.subjectNutrientsen
dc.titleAssociation between enteral macronutrient delivery and inflammatory response in critically ill children.en
dc.typeArticle
prism.endingPage2296
prism.issueIdentifier5en
prism.publicationDate2019en
prism.publicationNameClinical nutrition (Edinburgh, Scotland)en
prism.startingPage2287
prism.volume38en
dc.identifier.doi10.17863/CAM.33624
dcterms.dateAccepted2018-10-02en
rioxxterms.versionofrecord10.1016/j.clnu.2018.10.001en
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden
rioxxterms.licenseref.startdate2019-10en
dc.contributor.orcidZaher, Sara [0000-0002-7478-0113]
dc.contributor.orcidPathan, Nazima [0000-0002-9447-4252]
dc.identifier.eissn1532-1983
rioxxterms.typeJournal Article/Reviewen
pubs.funder-project-idEuropean Society of Intensive Care Medicine (ESICM) (ECCRN AWARD 2013)
pubs.funder-project-idEvelyn Trust (14/19)
rioxxterms.freetoread.startdate2019-10-11


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