Uptake of the 2020 ESPNIC nutrition recommendations across European pediatric intensive care units

Abstract Background The European Society of Pediatric and Neonatal Intensive Care (ESPNIC) published a systematic review with clinical recommendations around nutritional practice in Pediatric Intensive Care Units (PICUs) in 2020. Four years later we wanted to assess PICUs the perceived uptake of these recommendations across Europe. Methods A cross-sectional E-survey conducted in July-September 2024. European PICUs (1 response per unit) rated their implementation of each recommendation as fully, partly or not implemented at all. Results Fifty-three different PICUs from 13 European countries completed the survey. Most 36/53 (67.9%) respondents were PICU consultants, from general PICUs 24/53 (45.2%) and mixed cardiac and general PICUs 19/53 (35.8%). Of the 27 recommendations assessed, ‘full implementation’ was highest for use of a composite lipid formulation 47/53 (88.6%) and the lowest 9/53 (16.9%) for taking anthropometric measurements. The recommendations most frequently reported as ‘not implemented at all’ were measuring energy expenditure by indirect calorimetry 37/53 (69.8%), measuring gastric residuals to guide feeding 13/53 (24.5%), using the recommended Schofield equation to predict energy requirements12/53 (22.6%), using anthropometry to assess nutritional status 10/53 (18.8%) and delaying PN up to the first 7 days of admission 10/53 (18.8%). Conclusion Perceived uptake of the ESPNIC recommendations varied across European PICUs. Many of the recommendations were perceived to have been partly implemented, but this survey highlights areas for further education and research.