Sehr frühe parenterale Ernährung bei kritisch kranken pädiatrischen Patienten kann nachteilig sein: Überlegungen zur Interpretation der PEPaNIC-Studie

The influence of an early (within 24 h) vs. a late (from day 8) start of parenteral nutrition (PN) was investigated in 1440 pediatric intensive care patients in a prospective, randomized, controlled, multicenter investigation (PEPaNIC trial). The indications for PN were estimated on the basis of a nutrition screening score. The authors of the PEPaNIC investigation concluded on the basis of the study results that PN should generally be withheld for 1 week in pediatric intensive care patients. This publication presents the comments of the nutritional committee (NC) of the German Society for Pediatric and Adolescent Medicine (DGKJ) on the PEPaNIC investigation and the interpretation of the results by the authors. According to the view of the NC the data harvested from the PEPaNIC investigation do not show that it is beneficial for all pediatric intensive care patents to avoid PN for the first 8 days of intensive care treatment. Pediatric intensive care patients should initially receive oral or enteral nutrition adapted to their nutritional state. The amount should be increased depending on the individual nutritional tolerance and needs.