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Nutrition Practices and Outcomes in Pediatric Patients

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Pediatric Nutrition".

Deadline for manuscript submissions: closed (5 March 2024) | Viewed by 5026

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Prof. Dr. Theresa Mikhailov

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Department of Pediatrics, Division of Critical Care, Medical College of Wisconsin, Milwaukee, WI 53226, USA
Interests: pediatric critical and intensive care; pediatrics

Special Issue Information

Dear Colleagues,

Over the last few decades, a growing body of evidence has demonstrated the important relationship of clinical outcomes in pediatrics with both nutritional status and nutrition therapy. The impact of nutritional status and, in particular, malnutrition on clinical outcomes in children has been the focus of clinical research in inpatient and outpatient settings throughout the world. Similarly, the impact of various aspects of nutrition therapy on clinical outcomes has been the subject of clinical investigations into inpatient and outpatient management of acute, chronic, and critical illness. These aspects of nutrition therapy include the timing of initiation, rate of nutrition advancement, both the amount and route of nutrition delivery, and the macronutrient and micronutrient components of nutrition.

This Special Issue welcomes original human or animal model research that focuses on nutritional status and/or nutrition therapy in relation to clinical outcomes in children, primarily in the inpatient setting in various clinical conditions. The materials presented will be the result of international scientific cooperation of researchers specializing in these issues. The content may be useful for pediatric practitioners and may encourage further innovative research on this topic.

Prof. Dr. Theresa Mikhailov
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

pediatric
child
growth
clinical outcomes
nutritional status
malnutrition
obesity
nutrition therapy
macronutrient
micronutrient
metabolism
acute illness
chronic illness
critical illness

Published Papers (4 papers)

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Research

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10 pages, 1390 KiB

Open AccessArticle

Associations between Bronchopulmonary Dysplasia, Insulin-like Growth Factor I and Nutrition

by Dana F. J. Yumani, Floor H. Walschot, Harrie N. Lafeber and Mirjam M. van Weissenbruch

Nutrients 2024, 16(7), 957; https://doi.org/10.3390/nu16070957 - 27 Mar 2024

Viewed by 583

Abstract

Insulin-like growth factor I (IGF-I) has been suggested as an important factor in the pathogenesis of bronchopulmonary dysplasia (BPD). In turn, nutrition has been associated with IGF-I levels and could be of importance in the pathogenesis of BPD. This study aimed to explore the association between nutrition, the IGF-I axis and the occurrence of BPD. Eighty-six preterm infants (44 male, mean gestational age: 29.0 weeks (standard deviation: 1.7 weeks)) were enrolled in an observational study. Serum IGF-I (µg/L) and insulin-like growth factor binding protein 3 (IGFBP-3; mg/L) were measured at birth and at 2, 4 and 6 weeks postnatal age. BPD was diagnosed at 36 weeks postmenstrual age. Twenty-nine infants were diagnosed with BPD. For every µg/L per week increase in IGF-I, the odds of BPD decreased (0.68, 95% CI 0.48–0.96, corrected for gestational age). The change in IGF-I in µg/L/week, gestational age in weeks and a week of predominant donor human milk feeding were associated with the occurrence of BPD in the multivariable analysis (respectively, OR 0.63 (0.43–0.92), OR 0.44 (0.26–0.76) and 7.6 (1.2–50.4)). IGFBP-3 was not associated with the occurrence of BPD in the multivariable analysis. In conclusion, a slow increase in IGF-I levels and a lower gestational age increase the odds of BPD. Donor human milk might increase the odds of BPD and should be further explored. Full article

(This article belongs to the Special Issue Nutrition Practices and Outcomes in Pediatric Patients)

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9 pages, 512 KiB

Open AccessArticle

Nutrition Screening in the Pediatric Intensive Care Unit: Evaluation of an Electronic Medical Record-Based Tool

by Julia Hilbrands, Mary Beth Feuling, Aniko Szabo, Bi Q. Teng, Nicole Fabus, Melissa Froh, Rebecca Heisler, Olivia Lampone, Amber Smith, Theresa A. Mikhailov and Praveen S. Goday

Nutrients 2023, 15(21), 4591; https://doi.org/10.3390/nu15214591 - 28 Oct 2023

Viewed by 1088

Abstract

Hospitalized, critically ill children are at increased risk of developing malnutrition. While several pediatric nutrition screening tools exist, none have been validated in the pediatric intensive care units (PICU). The Children’s Wisconsin Nutrition Screening Tool (CWNST) is a unique nutrition screening tool that includes the Pediatric Nutrition Screening Tool (PNST) and predictive elements from the electronic medical record and was found to be more sensitive than the PNST in acute care units. The aim of this study was to assess the performance of the tool in detecting possible malnutrition in critically ill children. The data analysis, including the results of the current nutrition screening, diagnosis, and nutrition status was performed on all patients admitted to PICUs at Children’s Wisconsin in 2019. All 250 patients with ≥1 nutrition assessment by a dietitian were included. The screening elements that were predictive of malnutrition included parenteral nutrition, positive PNST, and BMI-for-age/weight-for-length z-score. The current screen had a sensitivity of 0.985, specificity of 0.06, positive predictive value (PPV) of 0.249, and negative predictive value of 0.929 compared to the PNST alone which had a sensitivity of 0.1, specificity of 0.981, PPV of 0.658, and NPV of 0.749. However, of the 250 included patients, 97.2% (243) had a positive nutrition screen. The CWNST can be easily applied through EMRs and predicts the nutrition risk in PICU patients but needs further improvement to improve specificity. Full article

(This article belongs to the Special Issue Nutrition Practices and Outcomes in Pediatric Patients)

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12 pages, 1148 KiB

Open AccessArticle

A Retrospective Study of Complications of Enteral Feeding in Critically Ill Children on Noninvasive Ventilation

by Montserrat Sierra-Colomina, Nagam Anna Yehia, Farhan Mahmood, Christopher Parshuram and Haifa Mtaweh

Nutrients 2023, 15(12), 2817; https://doi.org/10.3390/nu15122817 - 20 Jun 2023

Cited by 1 | Viewed by 1114

Abstract

The utilization of noninvasive ventilation (NIV) in pediatric intensive care units (PICUs), to support children with respiratory failure and avoid endotracheal intubation, has increased. Current guidelines recommend initiating enteral nutrition (EN) within the first 24–48 h post admission. This practice remains variable among PICUs due to perceptions of a lack of safety data and the potential increase in respiratory and gastric complications. The objective of this retrospective study was to evaluate the association between EN and development of extraintestinal complications in children 0–18 years of age on NIV for acute respiratory failure. Of 332 patients supported with NIV, 249 (75%) were enterally fed within the first 48 h of admission. Respiratory complications occurred in 132 (40%) of the total cohort and predominantly in non-enterally fed patients (60/83, 72% vs. 72/249, 29%; p < 0.01), and they occurred earlier during ICU admission (0 vs. 2 days; p < 0.01). The majority of complications were changes in the fraction of inspired oxygen (220/290, 76%). In the multivariate evaluation, children on bilevel positive airway pressure (BiPAP) (23/132, 17% vs. 96/200, 48%; odds ratio [OR] = 5.3; p < 0.01), receiving a higher fraction of inspired oxygen (FiO₂) (0.42 vs. 0.35; OR = 6; p = 0.03), and with lower oxygen saturation (SpO₂) (91% vs. 97%; OR = 0.8; p < 0.01) were more likely to develop a complication. Time to discharge from the intensive care unit (ICU) was longer for patients with complications (11 vs. 3 days; OR = 1.12; p < 0.01). The large majority of patients requiring NIV can be enterally fed without an increase in respiratory complications after an initial period of ICU stabilization. Full article

(This article belongs to the Special Issue Nutrition Practices and Outcomes in Pediatric Patients)

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Review

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26 pages, 442 KiB

Open AccessReview

Macronutrient and Micronutrient Intake in Children with Lung Disease

by Nicole Knebusch, Marwa Mansour, Stephanie Vazquez and Jorge A. Coss-Bu

Nutrients 2023, 15(19), 4142; https://doi.org/10.3390/nu15194142 - 25 Sep 2023

Cited by 1 | Viewed by 1682

Abstract

This review article aims to summarize the literature findings regarding the role of micronutrients in children with lung disease. The nutritional and respiratory statuses of critically ill children are interrelated, and malnutrition is commonly associated with respiratory failure. The most recent nutrition support guidelines for critically ill children have recommended an adequate macronutrient intake in the first week of admission due to its association with good outcomes. In children with lung disease, it is important not to exceed the proportion of carbohydrates in the diet to avoid increased carbon dioxide production and increased work of breathing, which potentially could delay the weaning of the ventilator. Indirect calorimetry can guide the process of estimating adequate caloric intake and adjusting the proportion of carbohydrates in the diet based on the results of the respiratory quotient. Micronutrients, including vitamins, trace elements, and others, have been shown to play a role in the structure and function of the immune system, antioxidant properties, and the production of antimicrobial proteins supporting the defense mechanisms against infections. Sufficient levels of micronutrients and adequate supplementation have been associated with better outcomes in children with lung diseases, including pneumonia, cystic fibrosis, asthma, bronchiolitis, and acute respiratory failure. Full article

(This article belongs to the Special Issue Nutrition Practices and Outcomes in Pediatric Patients)

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