ePICUre - Nutrition in paediatric critical care: a bi-national multi-centre prospective observational study

Abstract

ePICUre is a multi-centre, observational study of nutrition in critically ill children across Australia and New Zealand.

The study will review nutrition practices and resources in participating tertiary PICUs, and the nutritional status, management and associated outcomes for children aged 18 years and under admitted to the PICUs for >48 hours.

Primary Aim: To develop a platform to study nutrition in critically ill children in Australia and New Zealand that will inform paediatric nutrition care and research.

Objectives: Primary 1. To profile paediatric critical care nutrition management resources and practice in ANZ 2. To describe the nutritional status of children in ANZ PICUs 3. To better understand nutrition prescription and delivery in ANZ PICUs 4. To provide a benchmarking opportunity for nutrition practice in ANZ PICUs and provide participating sites with data to support quality improvement 5. To provide basic information to inform future paediatric critical care nutrition research questions and priorities

Secondary 6. To identify associations between nutrition and patient outcomes in ANZ PICUs 7. To compare change in nutrition practice between the two proposed study time points

Rationale: Further research is required to better understand the role of nutrition in paediatric critical care. Undernutrition has been found to be associated with poor clinical outcomes due to detrimental effects including impaired immune function, increased gut permeability and bacterial translocation, and impaired respiratory muscle function. The associated consequences of undernutrition include increased duration of mechanical ventilation, length of stay and mortality. In order to best determine future research directions, the nutritional status and nutrition management of this cohort must be described. Three large international studies of nutrition in paediatric critical care have been undertaken since 2009 however Australian and New Zealand Paediatric Intensive Care Units have not been widely represented.