Algemene kritieke zieke populatie. Groot scala aan aandoeningen en ziektebeelden mogelijk Critically ill children
Conditions
Interventions
The *Continuous Nutrition* strategy will be the nutritional management
currently recommended and acting as *control*. Both enteral nutrition (EN) and
(after day 7) parenteral nutrition (PN) will be
EN will
be started as early as possible (
Sponsors
Erasmus MC, Universitair Medisch Centrum Rotterdam
Eligibility
Age
No minimum to 17 Years
Inclusion criteria
Inclusion criteria: All critically ill children admitted to the PICU are evaluated for nutritional risk and eligibility for inclusion in this study. All critically ill children, (term born * 18 yrs), with expected stay at least two days, and dependent of artificial nutrition in PICU within 2 days are eligible for inclusion.
Exclusion criteria
Exclusion criteria: Exclusion criteria are possibility to *oral* feeds, a *do not resuscitate* code at the time of PICU admission, expected death within 24 hours, re-admission to the PICU >48 hours after previous inclusion to the ContInNuPIC trial, transfer from another ICU after a stay of three days or more or having received artificial nutrition, ketoacidotic/ hyperosmolar coma on admission, metabolic diseases requiring specific diet or with a contraindication to (intermittent) feeding, and premature newborns (
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The primary outcome of the proof-of-concept study will be the feasibility (nutritional intake, enteral tolerance) and safety (glycaemic control, gastro-intestinal complications) of a daily feeding and fasting cycle in critically ill children of different age-groups while providing equal amounts of daily nutrients as with standard continuous feeding. | — |
Secondary
| Measure | Time frame |
|---|---|
| Secondary parameters of the proof-of-concept study will be validating a fasting response in "Intermittent' as compared to "Continuous feeding by means of endocrine (IGF-I, T3/rT3, insulin, glucagon) and metabolic (glycaemic control, ketone production, lactate, bilirubin, urea, free fatty acids, autophagy) measurements, and the evaluation of the circadian rhythm (cortisol, melatonin, sleep quality, chrono-pharmacokinetics and vital sign variability). | — |
Countries
Netherlands
Outcome results
None listed