Dataset Information

Gastrointestinal biomarkers and their association with feeding in the first five days of pediatric critical illness.

ABSTRACT:

Objectives

Predicting the patients' tolerance to enteral nutrition (EN) would help clinicians optimize individual nutritional intake. This study investigated the course of several gastrointestinal (GI) biomarkers and their association with EN advancement (ENA) longitudinally during pediatric intensive care unit (PICU) admission.

Methods

This is a secondary analysis of the PEPaNIC RCT. EN was started early and increased gradually. The cholecystokinin (CCK), leptin, glucagon, intestinal fatty acid-binding protein 2 (I-FABP2), and citrulline plasma concentrations were measured upon PICU admission, day three and day five. ENA was defined as kcal EN provided as % of predicted resting energy expenditure (pREE). The course of the biomarkers and ENA was examined in patients with samples on all time points using Friedman and Wilcoxon signed-rank tests. The association of ENA with the biomarkers was examined using a two-part mixed-effects model with data of the complete population, adjusted for possible confounders.

Results

For 172 patients, median age 8.6 years (first quartile (Q1); third quartile (Q3): 4.2; 13.4), samples were available, of which 55 had samples on all time points. The median ENA was 0 (0; 0) on admission, 14.5 (0.0; 43.8) on day 3 and 28.0 (7.6; 94.8) on day 5. During PICU stay, CCK and I-FABP2 concentrations decreased significantly, whereas glucagon concentrations increased significantly, and leptin and citrulline remained stable. None of the biomarkers was longitudinally associated with ENA.

Conclusions

Based on the current evidence, CCK, leptin, glucagon, I-FABP2, and citrulline appear to have no added value in predicting ENA in the first five days of pediatric critical illness.

SUBMITTER: Veldscholte K

PROVIDER: S-EPMC10642702 | biostudies-literature | 2023 Sep

REPOSITORIES: biostudies-literature

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Publications

Gastrointestinal Biomarkers and Their Association with Feeding in the First Five Days of Pediatric Critical Illness.

Veldscholte Karlien K Hulst Jessie M JM Eveleens Renate D RD de Jonge Rogier C J RCJ de Koning Barbara A E BAE van den Berg Sjoerd A A SAA van der Wal Ronald R Ruijter George J G GJG Rizopoulos Dimitris D Vanhorebeek Ilse I Gunst Jan J Casaer Michaël M Van den Berghe Greet G Joosten Koen F M KFM Verbruggen Sascha C A T SCAT

Journal of pediatric gastroenterology and nutrition 20230920 6

<h4>Objectives</h4>Predicting the patients' tolerance to enteral nutrition (EN) would help clinicians optimize individual nutritional intake. This study investigated the course of several gastrointestinal (GI) biomarkers and their association with EN advancement (ENA) longitudinally during pediatric intensive care unit (PICU) admission.<h4>Methods</h4>This is a secondary analysis of the Early versus Late Parenteral Nutrition in the Pediatric Intensive Care Unit randomized controlled trial. EN wa ...[more]

PMID: 37728917

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