ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition

Background: Previous guidelines on Paediatric Parenteral Nutrition (PN) were published in 2010, by the European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and the European Society for Clinical Nutrition and Metabolism (ESPEN), supported by the European Society of Paediatric Research (ESPR) were published. The aim of the present paper was to provide up-to-date evidence for health professionals working with infants, children and adolescents receiving PN. Methods: The current document is a revision of the 2005 guidelines produced by the same 3 organizations (ESPEN, ESPGHAN, ESPR) together with the Chinese Society of Parenteral and Enteral Nutrition (CSPEN). Experts participating in the guideline updating process were all professionals with extensive experience in managing PN from a wide range of European countries, Israel and China. The guideline development process was coordinated by a guideline steering committee. Each chapter of the guideline was prepared by a separate author group. These author groups were responsible for screening titles and abstracts identified by a systematic literature search for inclusion, for conducting additional expert searches (including secondary sources such as other published valid guidelines), for evaluating the quality of studies included in the given chapter and assigning evidence levels to the literature. Based on the evidence level of included studies experts formulated and graded recommendations. A consensus conference was held in February 2015. All chapter manuscripts were revised following the recommendations of the consensus conference and then reviewed and edited by the project steering committee. Final consensus on each individual guideline and its individual recommendations was achieved and assessed by online voting. This process lasted until January 2018. Funding for the consensus conference (including travel expenses for participants) was provided by all participating societies. No other funding was received for the guideline updating process and participants received no payment. Support was provided by the Hungarian Cochrane organization. Results/conclusions: The present document provides guideline for the use of PN across the wide range of pediatric patients, ranging from extremely premature infants up to teenagers weighing up to and over 100 kg [[1]Mihatsch W. Shamir R. van Goudoever J.B. Fewtrell M. Lapillonne A. Lohner S. et al.ESPEN/ESPEN/ESPR/CSPEN Working Group on Pediatric Parenteral NutritionESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: guideline development process for the updated guidelines.Clin Nutr. 2018; 37: 2306-2308Abstract Full Text Full Text PDF PubMed Scopus (24) Google Scholar]. It covers their individual macro- and micronutrient needs [2Joosten K. Embleton N. Yan W. Senterre T. ESPGHAN/ESPEN/ESPR/CSPEN Working Group on Pediatric Parenteral NutritionESPGHAN/ESPEN/ESPR guidelines on pediatric parenteral nutrition: energy.Clin Nutr. 2018; 37: 2309-2314Abstract Full Text Full Text PDF Scopus (104) Google Scholar, 3van Goudoever J.B. Carnielli V. Darmaun D. Sainz de Pipaon M. ESPGHAN/ESPEN/ESPR/CSPEN Working Group on Pediatric Parenteral NutritionESPGHAN/ESPEN/ESPR guidelines on pediatric parenteral nutrition: amino acids.Clin Nutr. 2018; 37: 2315-2323Abstract Full Text Full Text PDF Scopus (103) Google Scholar, 4Lapillonne A. Fidler Mis N. Goulet O. van den Akker C.H.P. Wu J. Koletzko B. ESPGHAN/ESPEN/ESPR/CSPEN Working Group on Pediatric Parenteral NutritionESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: lipids.Clin Nutr. 2018; 37: 2324-2336Abstract Full Text Full Text PDF PubMed Scopus (114) Google Scholar, 5Mesotten D. Joosten K. van Kempen A. Verbruggen S. ESPGHAN/ESPEN/ESPR/CSPEN Working Group on Pediatric Parenteral NutritionESPGHAN/ESPEN/ESPR guidelines on pediatric parenteral nutrition: carbohydrates.Clin Nutr. 2018; 37: 2337-2343Abstract Full Text Full Text PDF Scopus (54) Google Scholar, 6Domellöf M. Szitanyi P. Simchowitz V. Franz A. Mimouni F. ESPGHAN/ESPEN/ESPR/CSPEN Working Group on Pediatric Parenteral NutritionESPGHAN/ESPEN/ESPR guidelines on pediatric parenteral nutrition: iron and trace minerals.Clin Nutr. 2018; 37: 2354-2359Abstract Full Text Full Text PDF PubMed Scopus (63) Google Scholar, 7Mihatsch W. Fewtrell M. Goulet O. Molgaard C. Picaud J.C. Senterre T. ESPGHAN/ESPEN/ESPR/CSPEN Working Group on Pediatric Parenteral NutritionESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: calcium, phosphorus and magnesium.Clin Nutr. 2018; 37: 2360-2365Abstract Full Text Full Text PDF PubMed Scopus (67) Google Scholar, 8Bronsky J. Campoy C. Braegger C. ESPGHAN/ESPEN/ESPR/CSPEN Working Group on Pediatric Parenteral NutritionESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: vitamins.Clin Nutr. 2018; 37: 2366-2378Abstract Full Text Full Text PDF PubMed Scopus (61) Google Scholar], fluid requirements [[9]Jochum F. Moltu S.J. Senterre T. Nomayo A. Goulet O. Iacobelli S. ESPGHAN/ESPEN/ESPR/CSPEN Working Group on Pediatric Parenteral NutritionESPGHAN/ESPEN/ESPR guidelines on pediatric parenteral nutrition: fluid and electrolytes.Clin Nutr. 2018; 37: 2344-2353Abstract Full Text Full Text PDF PubMed Scopus (58) Google Scholar], venous access [[10]Kolaček S. Puntis J.W.L. Hojsak I. ESPGHAN/ESPEN/ESPR/CSPEN Working Group on Pediatric Parenteral NutritionESPGHAN/ESPEN/ESPR guidelines on pediatric parenteral nutrition: venous access.Clin Nutr. 2018; 37: 2379-2391Abstract Full Text Full Text PDF PubMed Scopus (54) Google Scholar], organizational aspects [[11]Puntis J. Hojsak I. Ksiazyk J. ESPGHAN/ESPEN/ESPR/CSPEN Working Group on Pediatric Parenteral NutritionESPGHAN/ESPEN/ESPR guidelines on pediatric parenteral nutrition: organisational aspects.Clin Nutr. 2018; 37: 2392-2400Scopus (34) Google Scholar], home parenteral nutrition [[12]Hill S. Ksiazyk J. Prell C. Tabbers M. ESPGHAN/ESPEN/ESPR/CSPEN Working Group on Pediatric Parenteral NutritionESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: home parenteral nutrition.Clin Nutr. 2018; 37: 2401-2408Abstract Full Text Full Text PDF PubMed Scopus (39) Google Scholar], standardized vs. individualized PN [[13]Riskin A. Picaud J.C. Shamir R. ESPGHAN/ESPEN/ESPR/CSPEN Working Group on Pediatric Parenteral NutritionESPGHAN/ESPEN/ESPR guidelines on pediatric parenteral nutrition: standard versus individualized parenteral nutrition.Clin Nutr. 2018; 37: 2409-2417Scopus (45) Google Scholar], and last but not least a wide range of safety considerations for prevention and management of complications such central line associated bloodstream infections (CLABSI) [[14]Hartman C. Shamir R. Simchowitz V. Lohner S. Cai W. Decsi T. ESPGHAN/ESPEN/ESPR/CSPEN Working Group on Pediatric Parenteral NutritionESPGHAN/ESPEN/ESPR guidelines on pediatric parenteral nutrition: complications.Clin Nutr. 2018; 37: 2418-2429Abstract Full Text Full Text PDF PubMed Scopus (63) Google Scholar]. None declared.