Early Versus Late Parenteral Nutrition in the Pediatric Intensive Care Unit

Impact of Early Parenteral Nutrition Completing Enteral Nutrition in Paediatric Critically Ill Patients

In the PEPaNIC trial it is investigated whether withholding parenteral nutrition during the first week in critically ill children is beneficial, compared to the current standard of the early start of parenteral nutrition.

Inclusion Criteria:

• All patients admitted to the PICU with a STRONGkids score of 2 points or more upon ICU admission

Exclusion Criteria:

• Age of 17 years or older
• Patients with a DNR code at the time of ICU admission.
• Patients expected to die within 12 hours (=moribund patients).
• Patient readmitted to ICU after randomization to the PEPaNIC trial, more than 48 hours after the initial discharge
• Patients transferred from another paediatric intensive care after a stay of more than 7 days
• Patients suffering from ketoacidotic or hyperosmolar coma on admission.
• Patients suffering from Short Bowel Syndrome on home PN or other conditions that require home PN
• Patients suspicious or established inborn metabolic diseases requiring specific diet
• STRONGkids score lower than 2 on ICU admission.
• Premature Newborns ( 37 weeks gestational age upon admission in the PICU)
• Prior inclusion in another randomized controlled outcome study