FNCE 2023
Session 357. Providing MNT for the Pediatric Type 1 Diabetes Population: What Does the Evidence Show?
Monday, October 9, 8:30 AM - 9:30 AM
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  • Intervention
    Is there evidence of harm for certain populations of patients when they receive over 70% of their enteral nutrition goal intake?
    • Conclusion

      There is initial evidence in one trial of positive quality and one trial of neutral quality to suggest that achieving greater than 70% of goal intake may have less positive outcomes for medical ICU and surgical patients with obesity, when compared to individuals who received less EN.

    • Grade: III
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    What average amount of enteral nutrition intake actually delivered is associated with improved mortality in critically ill patients?
    • Conclusion

      To date, studies evaluating average amount of EN intake actually delivered have not been adequately powered to detect differences in mortality in critically ill patients.

    • Grade: III
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    What average amount of enteral nutrition intake actually delivered is associated with fewer infectious complications in critically ill patients?
    • Conclusion

      Actual delivery of intake of approximately or 60-70% of EN goal in the first week of ICU admission, is associated with fewer infectious complications in critically ill patients, particularly when initiated within 48 hours of injury or admission.

    • Grade: II
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    What average amount of enteral nutrition intake actually delivered is associated with a shorter length of hospital stay in critically ill patients?
    • Conclusion

      Actual delivery of intake of approximately 60-70% of EN goal in the first week of ICU admission, is associated with a shorter LOS in critically ill patients, particularly when initiated within 48 hours of injury or admission.

    • Grade: II
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    What average amount of enteral nutrition intake actually delivered is associated with less days of mechanical ventilation in critically ill patients?
    • Conclusion

      Actual delivery of intake of approximately 60-70% of EN goal in the first week of ICU admission, is associated with less days of mechanical ventilation in critically ill patients, particularly when initiated within 48 hours of injury or admission.

    • Grade: II
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
  • Monitoring and Evaluation
    What average amount of enteral nutrition intake actually delivered is associated with reduced cost of medical care in critically ill patients?
    • Conclusion

      To date, studies evaluating average amount of EN intake actually delivered have not been adequately powered to detect differences cost of medical care in critically ill patients.

    • Grade: III
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.