Evidence map›Paper›PMID 36306567›Full record

Observational studyClinical nutrition (Edinburgh, Scotland)2022

Intermittent versus continuous enteral nutrition in critically ill children: A pre-planned secondary analysis of an international prospective cohort study.

Enid E Martinez, Lori J Bechard, Ann-Marie Brown, Jorge A Coss-Bu, Sapna R Kudchadkar, Theresa A Mikhailov, Vijay Srinivasan, Steven J Staffa, S Sascha C A T Verbruggen, David Zurakowski and 1 more

Open access · greenAbstract readObservational Study
In one paragraph

Observational study in Clinical nutrition (Edinburgh, Scotland), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
0.9field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Chrononutrition in Critical Illness.Nutrition reviews · 2025
    Review
  5. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 7 institutions in 2 countries.

Enid E MartinezDivision of Critical Care Medicine, Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children's Hospital, USA; Harvard Medical School, Boston, MA, USA; Perioperative and Critical Care - Center for Outcomes Research (PC-CORE), Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children's Hospital, Boston, MA, USA.
Lori J BechardDivision of Critical Care Medicine, Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children's Hospital, USA; Harvard Medical School, Boston, MA, USA; Perioperative and Critical Care - Center for Outcomes Research (PC-CORE), Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children's Hospital, Boston, MA, USA.
Ann-Marie BrownNell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA.
Jorge A Coss-BuDivision of Critical Care Medicine, Baylor College of Medicine, Texas Children's Hospital, Austin, TX, USA.
Sapna R KudchadkarJohns Hopkins Children's Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Theresa A MikhailovMedical College of Wisconsin, Children's Hospital of Wisconsin, Milwaukee, WI, USA.
Vijay SrinivasanCritical Care Medicine, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
Steven J StaffaHarvard Medical School, Boston, MA, USA; Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children's Hospital, USA.
S Sascha C A T VerbruggenPediatric Intensive Care Unit, Sophia Children's Hospital, Erasmus University Medical Center, Rotterdam, NL, USA.
David ZurakowskiHarvard Medical School, Boston, MA, USA; Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children's Hospital, USA.
Nilesh M MehtaDivision of Critical Care Medicine, Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children's Hospital, USA; Harvard Medical School, Boston, MA, USA; Perioperative and Critical Care - Center for Outcomes Research (PC-CORE), Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children's Hospital, Boston, MA, USA. Electronic address: nilesh.mehta@childrens.harvard.edu.
Boston Children's Hospital · USChildren's Hospital of Philadelphia · USChildren's Hospital of Wisconsin · USEmory University · USErasmus MC · NLJohns Hopkins University · USTexas Children's Hospital · US

Funding

Protein Optimization with Exercise to Improve Muscle Mass and Functional Outcomes (PROXIMUS)R01DK132348 · NIDDK · BOSTON CHILDREN'S HOSPITAL · PI KUDCHADKAR, SAPNA R, MEHTA, NILESH M · 2022 to 2024
$1.0M
Evaluating the effect of zonulin-mediated intestinal trafficking on gastrointestinal macrophages and their function on gastric motilityK23DK128634 · NIDDK · BOSTON CHILDREN'S HOSPITAL · PI MARTINEZ, ENID E. · 2021 to 2024
$823k
NIDDK NIH HHS K23 DK128634NIDDK NIH HHS R01 DK132348
6 · The paper itself

Abstract

BACKGROUND &

aimsIntermittent enteral nutrition (EN) may have physiologic benefits over continuous feeding in critical illness. We aimed to compare nutrition and infection outcomes in critically ill children receiving intermittent or continuous EN.

methodsInternational, multi-center prospective observational study of mechanically ventilated children, 1 month to 18 years of age, receiving EN. Percent energy or protein adequacy (energy or protein delivered/prescribed × 100) and acquired infection rates were compared between intermittent and continuous EN groups using adjusted-multivariable and 4:1 propensity-score matched (PSM) analyses. Sensitivity analyses were performed after excluding patients who crossed over between intermittent and continuous EN.

results1375 eligible patients from 66 PICUs were included. Patients receiving continuous EN (N = 1093) had a higher prevalence of respiratory illness and obesity, and lower prevalence of neurologic illness and underweight status on admission, compared to those on intermittent EN (N = 282). Percent energy or protein adequacy, proportion of patients who achieved 60% of energy or protein adequacy in the first 7 days of admission, and rates of acquired infection were not different between the 2 groups in adjusted-multivariable and propensity score matching analyses (P > 0.05).

conclusionIntermittent versus continuous EN strategy is not associated with differences in energy or protein adequacy, or acquired infections, in mechanically ventilated, critically ill children. Until further evidence is available, an individualized feeding strategy rather than a universal approach may be appropriate.

Indexed as

Critical IllnessEnteral NutritionChildEatingHumansIntensive Care UnitsNutritional StatusProspective StudiesContinuousEnteral nutritionIntermittentOutcomesPediatric intensive care unit

Identifiers

PMID36306567
PMCPMC9722589
OpenAlexW4302009599

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.