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International Journal of Pediatrics، جلد ۱۲، شماره ۱۱، صفحات ۱۹۱۲۶-۱۹۱۳۹
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عنوان انگلیسی A Comprehensive Protocol for Safe and Effective Enteral Feeding in Critically Ill Pediatric Patients
چکیده انگلیسی مقاله Background: Nutritional support in the Pediatric Intensive Care Unit (PICU) is critical for promoting recovery and reducing complications in critically ill children. Although guidelines exist, variability in Enteral Nutrition (EN) practices underscores the need for standardized protocols tailored to the unique needs of PICU patients. This study aimed to develop a standardized enteral feeding protocol for PICU patients, informed by current evidence and expert consensus, to improve feeding tolerance and clinical outcomes.Methods: A two-phase study was conducted. Phase 1 involved a systematic review of global guidelines and evidence-based practices for EN in PICUs to identify key variables in EN delivery. In Phase 2, a multidisciplinary panel of PICU experts, including nutritionists and pediatric intensivists, used a structured focus group approach to develop a consensus on feeding initiation, volume advancement, prokinetic use, and complication management.Results: The resulting protocol recommends initiating EN within 24 hours for hemodynamically stable patients, with gradual, weight-based volume advancement tailored to patient tolerance. Prokinetic agents (metoclopramide, domperidone, and erythromycin) were incorporated to improve feeding tolerance; and guidelines for managing potential complications, such as refeeding syndrome, gastrointestinal issues, and electrolyte imbalances, were established.Conclusion: This protocol provides a comprehensive, evidence-based framework for EN in PICUs, offering structured guidance to support the nutritional needs of critically ill pediatric patients. While rigorous development ensures relevance and adaptability, further clinical evaluation is necessary to assess its impact across diverse PICU settings.
کلیدواژه‌های انگلیسی مقاله Critically ill children, Enteral Nutrition, Feeding protocol, Nutrition Support, Pediatric critical care, PICU, Prokinetics
نویسندگان مقاله | Faezeh Mashhadi
Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.


| Mostafa Shahraki
Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.


| Fatemeh Sadat Hashemi Javaheri
Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.


| Mohammad Safarian
Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.


| Majid Sezavar
Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.


| Gholamreza Khademi
Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.


| Maryam Naseri
Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.


| Fatemeh Roudi
Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
نشانی اینترنتی https://jpp.mums.ac.ir/article_25429.html
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زبان مقاله منتشر شده en
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نوع مقاله منتشر شده original article
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