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Delayed parenteral nutrition reduced new infections in critically ill children
  1. Rulla Al-Araji1,
  2. Rafeeq Muhammed2
  1. 1Department of General Paediatrics, Royal Stoke University Hospital, Stoke-on-Trent, Staffordshire, UK
  2. 2Department of Paediatric Gastroenterology and Nutrition, Birmingham Children’s Hospital, Birmingham, UK
  1. Correspondence to Dr Rulla Al-Araji, Department of General Paediatrics, Royal Stoke University Hospital, Stoke-on-Trent, Staffordshire, UK; rula_alaraji{at}

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Study question

In children admitted to paediatric intensive care units (PICU), is withholding parenteral nutrition (PN) for 1 week clinically superior to early PN?

Setting: Three tertiary PICUs in Belgium, the Netherlands and Canada.

Patients: All patients (term newborns to 17 years of age) admitted to the PICU with a STRONGkids score of 2 or more on admission.

STRONGkids score is the sum of: At risk of malnutrition or expected major surgery=2; poor nutritional status following clinical assessment=1; any of the following: excessive diarrhoea, reduced food intake, pre-existing nutritional intervention, poor nutrition due to pain=1, weight loss or no weight gain=1.

Patients who were not for resuscitation or expected to die within 12 hours, readmissions to PICU >48 hours after discharge or transferred from another PICU, suffering coma on admission, already enrolled in another RCT or suffering from conditions that required specific nutritional interventions (eg, on home PN or established metabolic disease) were excluded from the study.

Intervention: Early (first 24 hours) …

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