ePICUre

Nutrition in paediatric critical care: a bi-national multi-centre prospective observational study

ePICUre is a prospective observational cohort study including PICUs across Australia and New Zealand.

Primary Aim: To explore nutrition practice and provision for the duration of hospitalisation in critically ill children in Australia and New Zealand (ANZ) to inform nutrition care and research.

 

Objectives:

Primary:

  1. Profile nutrition resources and understand nutrition provision in ANZ PICUs
  2. Provide a benchmarking opportunity for participating sites
  3. Generate data to inform future paediatric critical nutrition research

Secondary:

  1. Establish a bi-national paediatric critical care nutrition research network
  2. Enhance the research capacity of ANZ PICU specialist dietitians

Rationale: Undernutrition in the paediatric critical care setting is associated with poor outcomes including impaired immune function, increased duration of mechanical ventilation, increased PICU and hospital length of stay, and increased mortality. Research activity continues to increase in this area of paediatric critical care. However, much remains unknown regarding the role of nutrition in the PICU and how ANZ practice compares to international practice and published guidelines. Current practice must be understood and periodically benchmarked to facilitate quality improvement and guide future research directions.

Study Progress: The study has been reviewed and approved in Australia by the Monash Health Human Research Ethics Committee (RES200000705A) and in New Zealand by the Northern B Health and Disability Ethics Committee (20/NTB/300). In 2021, ePICUre 1.0 enrolled 141 children across the nine ANZ specialist tertiary-affiliated PICUs. The 2024 ePICUre 2.0 study period was completed and enrolled 114 participants. A third data collection period is planned for 2026.

Registration: NCT06695078 – Clinicaltrials.gov

Endorsement: ePICUre 2.0 is endorsed by the Australian and New Zealand Intensive Care Society Paediatric Study Group (ANZICS-PSG) (PSG2024-09).

Funding: The 2021 study period was funded by the ANZIC-RC Nutrition Program. ePICUre 2.0 (2024 and 2026) is funded by the NHMRC Medical Research Future Fund (MRFF) Clinician Researchers (Nurses, Midwives and Allied Health) grant scheme (CIA A/Prof Emma Ridley).

Study Contact:

Publications:

Winderlich J, Little B, Oberender F et al. Dietitian and nutrition-related practices and resources in Australian and New Zealand PICUs: A clinician survey. Australian Critical Care 2024; 37, 3, 490-494. https://doi.org/10.1016/j.aucc.2023.03.003

Winderlich J, Little B, Oberender F et al. Nutrition provision in Australian and New Zealand PICUs: A prospective observational cohort study (ePICUre). Nutrition 2023; 118 112261 https://doi.org/10.1016/j.nut.2023.112261

Winderlich J, Little B, Oberender F et al. Characteristics of enteral and oral nutrition support among infants and young children in the pediatric intensive care unit: A descriptive cohort study. JPEN J Parenter Enteral Nutr 2024; https://doi.org/10.1002/jpen.2672

Winderlich J, Little B, Oberender F, Bollard T, Farrell T, Jenkins S, et al. Nutrition support in children discharged from the pediatric intensive care unit: A bi‐national prospective cohort study (ePICUre). Journal of Pediatric Gastroenterology and Nutrition. 2024 Oct 23; https://doi.org/10.1002/jpn3.12387