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class="bkr_bib"><h1 id="_NBK555668_"><span itemprop="name">Optimal timeframe to start parenteral nutrition</span></h1><div class="subtitle">Neonatal parenteral nutrition</div><p><b>Evidence review A2</b></p><p><i>NICE Guideline, No. 154</i></p><p class="contrib-group"><h4>Authors</h4><span itemprop="author">National Guideline Alliance (UK)</span>.</p><div class="half_rhythm">London: <a href="https://www.nice.org.uk" ref="pagearea=meta&targetsite=external&targetcat=link&targettype=publisher"><span itemprop="publisher">National Institute for Health and Care Excellence (NICE)</span></a>; <span itemprop="datePublished">2020 Feb</span>.<div class="small">ISBN-13: <span itemprop="isbn">978-1-4731-3673-1</span></div></div><div><a href="/books/about/copyright/">Copyright</a> © NICE 2020.</div></div><div class="bkr_clear"></div></div><div id="niceng154er2.s1"><h2 id="_niceng154er2_s1_">Optimal timeframe to starting parenteral nutrition</h2><div id="niceng154er2.s1.1"><h3>Review question</h3><p>For those neonates where parenteral nutrition is required, what is the optimal timeframe for doing this?</p><div id="niceng154er2.s1.1.1"><h4>Introduction</h4><p>Where provision of parenteral nutrition (PN) support has been agreed, the optimal timeframe for starting such support is important. Delaying provision of PN may lead to increased nutritional deficits, especially for the preterm infant, where body stores are low. However, provision of early PN exposes infants to the recognised risks of PN administration, such as electrolyte imbalance, metabolic disturbance or fluid overload.</p></div><div id="niceng154er2.s1.1.2"><h4>Summary of the protocol</h4><p>Please see <a class="figpopup" href="/books/NBK555668/table/niceng154er2.tab1/?report=objectonly" target="object" rid-figpopup="figniceng154er2tab1" rid-ob="figobniceng154er2tab1">Table 1</a> for a summary of the Population, Intervention, Comparison and Outcome (PICO) characteristics of this review.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng154er2tab1"><a href="/books/NBK555668/table/niceng154er2.tab1/?report=objectonly" target="object" title="Table 1" class="img_link icnblk_img figpopup" rid-figpopup="figniceng154er2tab1" rid-ob="figobniceng154er2tab1"><img class="small-thumb" src="/books/NBK555668/table/niceng154er2.tab1/?report=thumb" src-large="/books/NBK555668/table/niceng154er2.tab1/?report=previmg" alt="Table 1. Summary of the protocol (PICO table)." /></a><div class="icnblk_cntnt"><h4 id="niceng154er2.tab1"><a href="/books/NBK555668/table/niceng154er2.tab1/?report=objectonly" target="object" rid-ob="figobniceng154er2tab1">Table 1</a></h4><p class="float-caption no_bottom_margin">Summary of the protocol (PICO table). </p></div></div><p>For full details see the review protocol in <a href="#niceng154er2.appa">appendix A</a>.</p></div><div id="niceng154er2.s1.1.3"><h4>Clinical evidence</h4><div id="niceng154er2.s1.1.3.1"><h5>Included studies</h5><p>Four studies were identified for inclusion in this review (<a class="bibr" href="#niceng154er2.s1.ref1" rid="niceng154er2.s1.ref1">Brownlee 1993</a>, <a class="bibr" href="#niceng154er2.s1.ref2" rid="niceng154er2.s1.ref2">Dongming 2016</a>, <a class="bibr" href="#niceng154er2.s1.ref3" rid="niceng154er2.s1.ref3">Ibrahim 2004</a>, and <a class="bibr" href="#niceng154er2.s1.ref4" rid="niceng154er2.s1.ref4">van Puffelen 2018</a>).</p><p>Three randomised controlled trials (RCTs) compared early to late PN in preterm babies. One study (n=129) defined early PN as before 36 hours, and late as 6 days (<a class="bibr" href="#niceng154er2.s1.ref1" rid="niceng154er2.s1.ref1">Brownlee 1993</a>). One study (n=80) defined early PN as before 24 hours and late as 3 days (<a class="bibr" href="#niceng154er2.s1.ref2" rid="niceng154er2.s1.ref2">Dongming 2016</a>). One study (n=32) defined early PN as before 2 hours and late as 48 hours PN (<a class="bibr" href="#niceng154er2.s1.ref3" rid="niceng154er2.s1.ref3">Ibrahim 2004</a>). Due to the similarity in definitions for early PN in the <a class="bibr" href="#niceng154er2.s1.ref1" rid="niceng154er2.s1.ref1">Brownlee study (1993)</a> and late PN in the <a class="bibr" href="#niceng154er2.s1.ref3" rid="niceng154er2.s1.ref3">Ibrahim study (2004)</a>, 36 hours and 48 hours respectively, it was not appropriate to pool outcome data.</p><p>One RCT (n=209) compared early (within 24 hours of admission) to late (1 week) PN in term babies (<a class="bibr" href="#niceng154er2.s1.ref4" rid="niceng154er2.s1.ref4">van Puffelen 2018</a>).</p><p>The included studies are summarised in <a class="figpopup" href="/books/NBK555668/table/niceng154er2.tab2/?report=objectonly" target="object" rid-figpopup="figniceng154er2tab2" rid-ob="figobniceng154er2tab2">Table 2</a>.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng154er2tab2"><a href="/books/NBK555668/table/niceng154er2.tab2/?report=objectonly" target="object" title="Table 2" class="img_link icnblk_img figpopup" rid-figpopup="figniceng154er2tab2" rid-ob="figobniceng154er2tab2"><img class="small-thumb" src="/books/NBK555668/table/niceng154er2.tab2/?report=thumb" src-large="/books/NBK555668/table/niceng154er2.tab2/?report=previmg" alt="Table 2. Summary of included studies." /></a><div class="icnblk_cntnt"><h4 id="niceng154er2.tab2"><a href="/books/NBK555668/table/niceng154er2.tab2/?report=objectonly" target="object" rid-ob="figobniceng154er2tab2">Table 2</a></h4><p class="float-caption no_bottom_margin">Summary of included studies. </p></div></div><p>See the literature search strategy in <a href="#niceng154er2.appb">appendix B</a>, study selection flow chart in <a href="#niceng154er2.appc">appendix C</a>, study evidence tables in <a href="#niceng154er2.appd">appendix D</a>, forest plots in <a href="#niceng154er2.appe">appendix E</a>, and GRADE tables in <a href="#niceng154er2.appf">appendix F</a>.</p></div><div id="niceng154er2.s1.1.3.2"><h5>Excluded studies</h5><p>Studies not included in this review are listed, and reasons for their exclusions are provided, in <a href="#niceng154er2.appk">appendix K</a>.</p></div></div><div id="niceng154er2.s1.1.4"><h4>Summary of clinical studies included in the evidence review</h4><p>Summaries of the studies that were included in this review are presented <a class="figpopup" href="/books/NBK555668/table/niceng154er2.tab2/?report=objectonly" target="object" rid-figpopup="figniceng154er2tab2" rid-ob="figobniceng154er2tab2">Table 2</a>.</p><p>See <a href="#niceng154er2.appd">appendix D</a> for the full evidence tables.</p></div><div id="niceng154er2.s1.1.5"><h4>Quality assessment of clinical outcomes included in the evidence review</h4><p>GRADE was conducted to assess the quality of outcomes. Evidence was identified for critical and important outcomes. The clinical evidence profiles can be found in <a href="#niceng154er2.appf">appendix F</a>.</p></div><div id="niceng154er2.s1.1.6"><h4>Economic evidence</h4><div id="niceng154er2.s1.1.6.1"><h5>Included studies</h5><p>A systematic review of the economic literature was conducted but no economic studies were identified which were applicable to this review question. A single economic search was undertaken for all topics included in the scope of this guideline. Please see <a href="/books/NBK555668/bin/niceng154er2_bm4.pdf">supplementary material D</a> for details.</p></div><div id="niceng154er2.s1.1.6.2"><h5>Excluded studies</h5><p>No studies were identified which were applicable to this review question.</p></div></div><div id="niceng154er2.s1.1.7"><h4>Summary of studies included in the economic evidence review</h4><p>No economic evaluations were identified which were applicable to this review question.</p></div><div id="niceng154er2.s1.1.8"><h4>Economic model</h4><p>This question was medium priority for economic evaluation. However, the identified clinical data was insufficient to inform de-novo economic modelling in this area.</p></div><div id="niceng154er2.s1.1.9"><h4>Evidence statements</h4><div id="niceng154er2.s1.1.9.1"><h5>Clinical evidence statements</h5><div id="niceng154er2.s1.1.9.1.1"><h5>Early versus late parenteral nutrition in preterm babies</h5><div id="niceng154er2.s1.1.9.1.1.1"><h5>Weight gain</h5><ul><li class="half_rhythm"><div>Very low quality evidence from 1 RCT (n=129) showed no clinically important difference in weight gain at 2 weeks in babies who had received early PN (36 hours) as compared to late PN (6 days). However, there was uncertainty around the effect: Mean difference (MD) 13g (95% CI −3.92 to 29.92).</div></li><li class="half_rhythm"><div>Very low quality evidence from 1 RCT (n=129) showed no clinically important difference in weight gain per day until discharge between babies who received early PN (36 hours) as compared to late PN (6 days). However, there was uncertainty around the effect: MD 2.4g (95% CI −5.3 to 0.5).</div></li></ul></div><div id="niceng154er2.s1.1.9.1.1.2"><h5>Hyperglycaemia</h5><ul><li class="half_rhythm"><div>Very low quality evidence from 1 RCT (n=80) showed a clinically important difference in the number of babies with hyperglycaemia between those who received early PN (24 hours) as compared to late PN (3 days), with fewer occurrences of hyperglycaemia in babies given early PN. However, there was high uncertainty around the effect: Relative risk (RR) 0.33 (95% CI 0.04 to 3.07)</div></li></ul></div><div id="niceng154er2.s1.1.9.1.1.3"><h5>Sepsis</h5><ul><li class="half_rhythm"><div>Very low quality evidence from 1 RCT (n=29) showed no clinically important difference in the number of babies with sepsis between those who received early PN (within 2 hours) as compared to late PN (within 48 hours). However, there was high uncertainty around the effect: RR 0.92 (95% CI 0.41 to 2.07).</div></li></ul></div><div id="niceng154er2.s1.1.9.1.1.4"><h5>Mortality</h5><ul><li class="half_rhythm"><div>Very low quality evidence from 1 RCT (n=129) showed no clinically important difference in mortality between those who received early PN (36 hours) as compared to late PN (6 days). However, there was high uncertainty around the effect: RR 0.82 (95% CI 0.4 to 1.67).</div></li><li class="half_rhythm"><div>Very low quality evidence from 1 RCT (n=29) showed a clinically important difference in mortality of babies between those who received early PN (within 2 hours) as compared to late PN (within 48 hours), with fewer occurrences of mortality in those given early PN. However, there was high uncertainty around the effect: RR 0.5 (95% CI 0.05 to 4.98).</div></li></ul></div><div id="niceng154er2.s1.1.9.1.1.5"><h5>Caloric intake</h5><ul><li class="half_rhythm"><div>Moderate quality evidence from 1 RCT (n=32) showed a clinically important difference in calorie intake between babies who received early PN (within 2 hours) as compared to those who received late PN (within 48 hours) with a greater intake associated with a later start of PN: MD 18.4kcal (95% CI 17.22 to 19.58)</div></li></ul></div></div><div id="niceng154er2.s1.1.9.1.2"><h5>Early versus late parenteral nutrition in critically ill, term babies</h5><div id="niceng154er2.s1.1.9.1.2.1"><h5>Paediatric intensive care unit (PICU) acquired infections</h5><ul><li class="half_rhythm"><div>Low quality evidence from 1 RCT (n=209) showed a clinically important difference in the number of babies with PICU acquired infections between those who received early PN (within 24 hours) as compared to late PN (after 1 week), with more occurrences of infection in those given early PN. However, there was uncertainty around the effect: RR 1.89 (95% CI 1.13 to 3.17).</div></li><li class="half_rhythm"><div>Low quality evidence from the same RCT (n=38) showed a clinically important difference in the number of babies with PICU acquired infections between those who received early PN (within 24 hours) as compared to late PN (after 1 week), with more occurrences of infection in those given early PN, in a subsample of babies who received no or minimal enteral nutrition. However, there was uncertainty around the effect: RR 1.49 (95% CI 0.81 to 2.73).</div></li></ul></div><div id="niceng154er2.s1.1.9.1.2.2"><h5>Hypoglycaemia during the first week</h5><ul><li class="half_rhythm"><div>Low quality evidence from 1 RCT (n=209) showed a clinically important difference in the number of babies with hypoglycaemia between those who received early PN (within 24 hours) as compared to late PN (after 1 week), with fewer occurrences of hypoglycaemia in those given early PN. However, there was uncertainty around the effect: RR 0.61 (95% CI 0.34 to 1.10).</div></li><li class="half_rhythm"><div>Low quality evidence from the same RCT (n=38) showed a clinically important difference in the number of babies with hypoglycaemia between those who received early PN (within 24 hours) as compared to late PN (after 1 week), with fewer occurrences of hypoglycaemia in those given early PN, in a subsample of babies who received no or minimal enteral nutrition. However, there was uncertainty around the effect: RR 0.33 (95% CI 0.12 to 0.89).</div></li></ul></div><div id="niceng154er2.s1.1.9.1.2.3"><h5>Mortality at 90 days</h5><ul><li class="half_rhythm"><div>Low quality evidence from 1 RCT (n=209) showed a clinically important difference in mortality between those who received early PN (within 24 hours) as compare to late PN (after 1 week), with more occurrences of mortality in those given early PN. However, there was uncertainty around the effect: RR 2.83 (95% CI 1.14 to 7.01).</div></li><li class="half_rhythm"><div>Very low quality evidence from 1 RCT (n=38) showed a clinically important difference in mortality between those who received early PN (within 24 hours) as compare to late PN (after 1 week), with more occurrences of mortality in those given early PN, in a subsample of babies who received no or minimal enteral nutrition. However, there was high uncertainty around the effect: RR 2.28 (95% CI 0.55 to 9.54).</div></li></ul></div></div></div><div id="niceng154er2.s1.1.9.2"><h5>Economic evidence statements</h5><p>No studies were identified which were applicable to this review question.</p></div></div><div id="niceng154er2.s1.1.10"><h4>The committee’s discussion of the evidence</h4><div id="niceng154er2.s1.1.10.1"><h5>Interpreting the evidence</h5><div id="niceng154er2.s1.1.10.1.1"><h5>The outcomes that matter most</h5><p>The committee agreed that the critical outcomes were neurodevelopmental outcomes, growth and body composition. These were agreed as a delay in PN provision is likely to have direct effects on these anthropometric measures (i.e. growth and body composition) and also on the development of the brain. Infection and adverse events were also considered critical as these may occur as part of the practicalities of administration of PN. The committee agreed mortality, duration of hospital stay and nutrient intake should be considered as important outcomes; although influenced by PN other factors may impact on mortality and duration of hospital stay. The committee did not think the nutrient intake was as critical as the effect of intake on the individual baby (i.e. as long as the baby is growing, the detailed nutrient intake in itself is less important due to multiple influences on metabolism).</p></div><div id="niceng154er2.s1.1.10.1.2"><h5>The quality of the evidence</h5><p>The quality of evidence for this review was assessed using GRADE methodology. The evidence presented was mainly considered very low quality, indicating high uncertainty in the reliability of the data, with the exception of caloric intake which was considered moderate quality. Evidence was downgraded due to serious or very serious risk of bias associated with unclear methods of allocation, unclear concealment of allocation, and unclear blinding of assessors. In addition, the studies had small sample sizes leading to imprecision.</p><p>Another quality issue that the committee considered was the applicability or generalisability of the studies. The committee acknowledged that the evidence presented reflected how clinical practice has changed over time, as the earlier studies started PN later than what would now be considered good clinical practice.</p></div><div id="niceng154er2.s1.1.10.1.3"><h5>Benefits and harms</h5><p>The evidence on preterm babies presented in this review was heterogeneous regarding what was defined as early (ranged from 2 hours to 36 hours without very clear descriptions of the enteral feeding regimen). There was also no consistent pattern of findings. While none of the outcomes favoured late administration only a couple of them clearly indicated better outcomes associated with an earlier start of PN (fewer babies with hyperglycaemia and lower mortality). Other outcomes suggested no clear difference (weight gain and sepsis) and there was a higher caloric intake associated with later start (which is difficult to interpret as favouring either early or late). The evidence for all outcomes, apart from caloric intake, was rated as very low quality, and there were also limitations in its applicability to current clinical practice (most studies were old and were not considered to provide PN formulations that would now be considered optimal). Due to these issues, the committee had low confidence in the evidence and therefore made the recommendations using informal consensus, based on their clinical experience and expertise.</p><p>There was one study comparing early (within 24 hours) and late (after 1 week) provision of PN in term babies. There was evidence of greater rates of infection and mortality when PN was provided early compared with late, but lower rates of hypoglycaemia. These differences were observed both in the whole group of babies, and a subgroup who received no or minimal enteral nutrition. However, evidence was all low or very low quality.</p><p>The committee noted that some of the included studies specified a timeframe of two hours. They discussed that these were randomised controlled trials, which would have clear protocols and service arrangements in place that would make it possible for the participating centres to adhere to this schedule. The committee agreed that PN should be given as soon as possible once the decision to start PN (see evidence review A1 for the predictors of enteral feeding success) has been made and the earlier the better which was supported by some of the evidence. However, they decided that two hours would be unrealistic and likely to have a large resource impact, and that out-of-hours services could make such a timeframe unachievable. They therefore balanced the benefits of early administration (better nutrition) with the logistic challenges of adhering to a specific timeframe and decided that within eight hours would be both safe and achievable. Based on their experience the committee agreed that eight hours would not detrimentally affect growth outcomes. They also agreed that in certain circumstances, for example when a preterm baby requires PN or a term baby is critically unwell, or a baby has surgical problems, there are several competing treatment priorities; it may be the case that resuscitative measures must take precedence over the provision of PN, and therefore, a recommendation to give PN in under two hours could adversely affect essential treatment prioritisation. The committee provided examples of achievable timeframes from different levels of neonatal units, ranging from three hours to 17 hours; therefore, they agreed that a “within timeframe” recommendation was the most appropriate recommendation, and that based on their clinical experience and expertise, eight hours is both achievable and safe.</p><p>The committee discussed the possibility of giving a longer timeframe to start PN, but they were concerned that in practice this would be exceeded. It was agreed that stating a shorter timeframe would highlight the importance of starting PN as soon as possible. However, they agreed that this can vary in different situations, for example a moderately term baby may be tried on enteral feeds for a while before the decision is made for them to get PN. This would therefore be a delay in starting PN. They therefore intentionally phrased this to include the wording of ‘when a baby meets the indications for parenteral nutrition” to indicate that the decision is not always clear cut (as in 8 hours after the baby is born).</p><p>The committee discussed whether different timeframes should be recommended for preterm and term babies. They discussed the evidence on critically ill term babies showing an increased risk of infection and mortality, but decreased hypoglycaemia, associated with the earlier start They noted that this evidence was from a pre-planned subgroup analysis (which was small), the parenteral nutrition regimens used were not consistent across the different study sites and the intervention may not have been appropriate because parenteral nutrition would not normally be started on day 1 for critically ill term babies due to restricted fluid volumes and strain on organ systems. They therefore agreed that there was too much uncertainty to suggest a longer time to start based on these findings.</p><p>They agreed that without PN preterm babies will develop a nutritional deficit more rapidly than term babies; therefore, the committee decided that it may take longer to come to a decision whether PN in term babies is needed. Reaching this conclusion may take longer because term babies have greater nutritional reserves. However, once the decision is made that PN is needed, it should be started within eight hours, regardless of whether babies are term or preterm.</p><p>Having identified the limitations of the evidence, the committee agreed that there is a need for further research in this area in clearly defined populations (i.e. critically ill term babies and surgical babies). Identifying the timeframe for starting PN administration is crucial to ensure optimum care is provided and to improve outcomes for babies. They therefore made a research recommendation, by informal consensus, to address this topic in clearly defined populations.</p></div></div><div id="niceng154er2.s1.1.10.2"><h5>Cost effectiveness and resource use</h5><p>There was no existing economic evidence on the cost-effectiveness of an earlier versus later start of PN. The committee acknowledged the inconclusive clinical evidence in this area. However, according to the committee’s expertise alongside the limited clinical evidence presented it was concluded that early initiation of PN would have the benefit of adequate nutritional intake to support early development when compared to the late initiation of PN. In regards to costs, earlier initiation of PN is likely to reduce nutritional deficits arising which reduces the costs associated with dealing with those nutritional deficits. The total length of time PN is given for is closely tied to enteral feed tolerance and not just dependant on the time PN is started. Starting PN later would not necessarily result in a shorter duration of PN as the delayed nutritional delivery has the potential to reduce growth. Additionally, the recommendation to start PN earlier is likely to be most easily achieved through the use of standardised PN bags as opposed to bespoke PN bags. In general, standardised PN bags are cheaper than bespoke ones so this may lead to cost savings. Additionally, the committee felt the better outcomes for a baby initiated on earlier PN meant that this was the preferred strategy and therefore the benefits would outweigh the costs.</p></div><div id="niceng154er2.s1.1.10.3"><h5>Other factors the committee took into account</h5><p>The committee agreed that the use of standardised bags (which is recommended by the committee and discussed in evidence review E) would facilitate neonatal units to achieve this timeframe target because standardised bags would be readily available to administer when the decision has been made to start PN.</p></div></div></div><div id="niceng154er2.rl.r1"><h3>References</h3><ul class="simple-list"><li class="half_rhythm"><p><div class="bk_ref" id="niceng154er2.s1.ref1"><p id="p-144">
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<strong>Brownlee 1993</strong>
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</p>Brownlee, K. G., Kelly, E. J., Ng, P. C., Kendall-Smith, S. C., Dear, P. R., Early or late parenteral nutrition for the sick preterm infant?, Archives of disease in childhood, 69, 281–3, 1993 [<a href="/pmc/articles/PMC1029492/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC1029492</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/8215565" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8215565</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng154er2.s1.ref2"><p id="p-145">
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<strong>Dongming 2016</strong>
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</p>Lang, Dongming, Zhou, Fengran, Zhang, Zhaojun, The study of early intravenous nutrition therapy in very low birth weight infants, Pakistan journal of pharmaceutical sciences, 29, 2293–2295, 2016 [<a href="https://pubmed.ncbi.nlm.nih.gov/28167468" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28167468</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng154er2.s1.ref3"><p id="p-146">
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<strong>Ibrahim 2004</strong>
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</p>Ibrahim, Hassan M., Jeroudi, Majied A., Baier, R. J., Dhanireddy, Ramasubbareddy, Krouskop, Richard W., Aggressive early total parental nutrition in low-birth-weight infants, Journal of perinatology : official journal of the California Perinatal Association, 24, 482–6, 2004 [<a href="https://pubmed.ncbi.nlm.nih.gov/15167885" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15167885</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng154er2.s1.ref4"><p id="p-147">
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<strong>Van Puffelen 218</strong>
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</p>van Puffelen, E., Vanhorebeek, I., Joosten, K. F. M., Wouters, P. J., Van den Berghe, G., Verbruggen, Scat, Early versus late parenteral nutrition in critically ill, term neonates: a preplanned secondary subgroup analysis of the PEPaNIC multicentre, randomised controlled trial, The lancet child and adolescent health, 2, 505–515, 2018 [<a href="https://pubmed.ncbi.nlm.nih.gov/30169323" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30169323</span></a>]</div></p></li></ul></div></div><div id="appendixesappgroup1"><h2 id="_appendixesappgroup1_">Appendices</h2><div id="niceng154er2.appa"><h3>Appendix A. Review protocols</h3><div id="niceng154er2.appa.s1"><h4>Review protocol for review question: For those neonates where parenteral nutrition is required, what is the optimal timeframe for doing this?</h4><p id="niceng154er2.appa.tab1"><a href="/books/NBK555668/table/niceng154er2.appa.tab1/?report=objectonly" target="object" rid-ob="figobniceng154er2appatab1" class="figpopup">Table 3. Review protocol – optimal timeframe to starting PN</a></p></div></div><div id="niceng154er2.appb"><h3>Appendix B. Literature search strategies</h3><div id="niceng154er2.appb.s1"><h4>Literature search strategy for review question: For those neonates where parenteral nutrition is required, what is the optimal timeframe for doing this?</h4><p id="niceng154er2.appb.tab1"><a href="/books/NBK555668/table/niceng154er2.appb.tab1/?report=objectonly" target="object" rid-ob="figobniceng154er2appbtab1" class="figpopup">Databases: Medline; Medline EPub Ahead of Print; and Medline In-Process & Other Non-Indexed Citations</a></p><p id="niceng154er2.appb.tab2"><a href="/books/NBK555668/table/niceng154er2.appb.tab2/?report=objectonly" target="object" rid-ob="figobniceng154er2appbtab2" class="figpopup">Databases: Embase; and Embase Classic</a></p><p id="niceng154er2.appb.tab3"><a href="/books/NBK555668/table/niceng154er2.appb.tab3/?report=objectonly" target="object" rid-ob="figobniceng154er2appbtab3" class="figpopup">Databases: Cochrane Central Register of Controlled Trials; Cochrane Database of Systematic Reviews; Database of Abstracts of Reviews of Effects; and Health Technology Assessment</a></p></div></div><div id="niceng154er2.appc"><h3>Appendix C. Clinical evidence study selection</h3><div id="niceng154er2.appc.s1"><h4>Clinical study selection for review question: For those neonates where parenteral nutrition is required, what is the optimal timeframe for doing this?</h4><p id="niceng154er2.appc.fig1"><a href="/books/NBK555668/figure/niceng154er2.appc.fig1/?report=objectonly" target="object" rid-ob="figobniceng154er2appcfig1" class="figpopup">Figure 1. PRISMA Flow chart of clinical article selection for review question, for those neonates where PN is required, what is the optimal timeframe?</a></p></div></div><div id="niceng154er2.appd"><h3>Appendix D. Clinical evidence tables</h3><div id="niceng154er2.appd.s1"><h4>Clinical evidence tables for review question: For those neonates where parenteral nutrition is required, what is the optimal timeframe for doing this? In babies on parenteral nutrition, what is the optimal frequency of blood sampling and monitoring?</h4><p id="niceng154er2.appd.et1"><a href="/books/NBK555668/bin/niceng154er2-appd-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Table 4. Clinical evidence tables for included studies</a><span class="small"> (PDF, 429K)</span></p></div></div><div id="niceng154er2.appe"><h3>Appendix E. Forest plots</h3><div id="niceng154er2.appe.s1"><h4>Forest plots for review question: For those neonates where parenteral nutrition is required, what is the optimal timeframe for doing this?</h4><p>No meta-analysis was conducted for this review; therefore there are no forest plots</p></div></div><div id="niceng154er2.appf"><h3>Appendix F. GRADE tables</h3><div id="niceng154er2.appf.s1"><h4>GRADE tables for review question: For those neonates where parenteral nutrition is required, what is the optimal timeframe for doing this?</h4><p id="niceng154er2.appf.tab1"><a href="/books/NBK555668/table/niceng154er2.appf.tab1/?report=objectonly" target="object" rid-ob="figobniceng154er2appftab1" class="figpopup">Table 5. Clinical evidence profile for early versus late delivery of parenteral nutrition in preterm babies</a></p><p id="niceng154er2.appf.tab2"><a href="/books/NBK555668/table/niceng154er2.appf.tab2/?report=objectonly" target="object" rid-ob="figobniceng154er2appftab2" class="figpopup">Table 6. Clinical evidence profile for early versus late parenteral nutrition in critically ill, term babies</a></p></div></div><div id="niceng154er2.appg"><h3>Appendix G. Economic evidence study selection</h3><div id="niceng154er2.appg.s1"><h4>Economic evidence study selection for review question: For those neonates where parenteral nutrition is required, what is the optimal timeframe for doing this?</h4><p>One global search was conducted for all review questions. See <a href="/books/NBK555668/bin/niceng154er2_bm4.pdf">supplementary material D</a> for further information.</p></div></div><div id="niceng154er2.apph"><h3>Appendix H. Economic evidence tables</h3><div id="niceng154er2.apph.s1"><h4>Economic evidence tables for review question: For those neonates where parenteral nutrition is required, what is the optimal timeframe for doing this?</h4><p>No economic studies were identified which were applicable to this review question.</p></div></div><div id="niceng154er2.appi"><h3>Appendix I. Economic evidence profiles</h3><div id="niceng154er2.appi.s1"><h4>Economic evidence profiles for review question: For those neonates where parenteral nutrition is required, what is the optimal timeframe for doing this?</h4><p>No economic studies were identified which were applicable to this review question.</p></div></div><div id="niceng154er2.appj"><h3>Appendix J. Economic analysis</h3><div id="niceng154er2.appj.s1"><h4>Economic analysis for review question: For those neonates where parenteral nutrition is required, what is the optimal timeframe for doing this?</h4><p>No economic analysis was undertaken for this review question.</p></div></div><div id="niceng154er2.appk"><h3>Appendix K. Excluded studies</h3><div id="niceng154er2.appk.s1"><h4>Excluded studies for review question: For those neonates where PN is required what is the optimal timeframe for doing this?</h4><div id="niceng154er2.appk.s1.1"><h5>Clinical studies</h5><p id="niceng154er2.appk.tab1"><a href="/books/NBK555668/table/niceng154er2.appk.tab1/?report=objectonly" target="object" rid-ob="figobniceng154er2appktab1" class="figpopup">Table 7. Excluded studies and reasons for their exclusion</a></p></div><div id="niceng154er2.appk.s1.2"><h5>Economic studies</h5><p>No economic evidence was identified for this review question. See <a href="/books/NBK555668/bin/niceng154er2_bm4.pdf">supplementary material D</a> for further information.</p></div></div></div><div id="niceng154er2.appl"><h3>Appendix L. Research recommendations</h3><div id="niceng154er2.appl.s1"><h4>Research recommendations for review question: For those neonates where PN is required what is the optimal timeframe for doing this?</h4><div id="niceng154er2.appl.s1.1"><h5>Research recommendation</h5><p>What is the optimal timeframe for starting parenteral nutrition in term babies who are critically ill or who require surgery?</p></div><div id="niceng154er2.appl.s1.2"><h5>Why this is important</h5><p>Where provision of parenteral nutrition (PN) has been agreed, the optimal timeframe for starting such support is important. Delaying the provision of PN may lead to increased nutritional deficits, and this is especially important in preterm babies who lack nutritional stores and for babies who are critically ill or babies who require surgery. Some evidence was identified for preterm babies; however, there was little evidence for term babies who are critically ill or babies requiring surgery.</p><p id="niceng154er2.appl.tab1"><a href="/books/NBK555668/table/niceng154er2.appl.tab1/?report=objectonly" target="object" rid-ob="figobniceng154er2appltab1" class="figpopup">Table 8. Research recommendation rationale</a></p><p id="niceng154er2.appl.tab2"><a href="/books/NBK555668/table/niceng154er2.appl.tab2/?report=objectonly" target="object" rid-ob="figobniceng154er2appltab2" class="figpopup">Table 9. Research recommendation modified PICO table</a></p></div></div></div></div></div><div class="fm-sec"><div><p>Final</p></div><div><p>Evidence reviews</p><p>These evidence reviews were developed by the National Guideline Alliance which is part of the Royal College of Obstetricians and Gynaecologists</p></div><div><p><b>Disclaimer</b>: The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The recommendations in this guideline are not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.</p><p>Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties.</p><p>NICE guidelines cover health and care in England. Decisions on how they apply in other UK countries are made by ministers in the <a href="http://wales.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Welsh Government</a>, <a href="http://www.scotland.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Scottish Government</a>, and <a href="http://www.northernireland.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Northern Ireland Executive</a>. All NICE guidance is subject to regular review and may be updated or withdrawn.</p></div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright</a> © NICE 2020.</div><div class="small"><span class="label">Bookshelf ID: NBK555668</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/32282160" title="PubMed record of this title" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">32282160</a></span></div></div><div class="small-screen-prev"></div><div class="small-screen-next"></div></article><article data-type="table-wrap" id="figobniceng154er2tab1"><div id="niceng154er2.tab1" class="table"><h3><span class="label">Table 1</span><span class="title">Summary of the protocol (PICO table)</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK555668/table/niceng154er2.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng154er2.tab1_lrgtbl__"><table class="no_bottom_margin"><tbody><tr><th id="hd_b_niceng154er2.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><td headers="hd_b_niceng154er2.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul><li class="half_rhythm"><div>Babies born preterm, up to 28 days after their due birth date (preterm babies)</div></li><li class="half_rhythm"><div>Babies born at term, up to 28 days after their birth (term babies)</div></li></ul></td></tr><tr><th id="hd_b_niceng154er2.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention</th><td headers="hd_b_niceng154er2.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Early start of PN<sup>*</sup></td></tr><tr><th id="hd_b_niceng154er2.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comparison</th><td headers="hd_b_niceng154er2.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Late start of PN<sup>*</sup></td></tr><tr><th id="hd_b_niceng154er2.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><td headers="hd_b_niceng154er2.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><b>Critical</b>
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<ul><li class="half_rhythm"><div>Neurodevelopmental outcomes (general cognitive abilities at two years corrected age as measured by a validated scale)</div></li><li class="half_rhythm"><div>Growth:
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<ul class="circle"><li class="half_rhythm"><div>Weight gain (g/kg/d)</div></li><li class="half_rhythm"><div>Linear growth</div></li><li class="half_rhythm"><div>Head circumference (mm)</div></li></ul></div></li><li class="half_rhythm"><div>Infection (including sepsis)</div></li><li class="half_rhythm"><div>Body composition (measured as lean mass, fat-free mass, fat mass, adipose tissue)</div></li><li class="half_rhythm"><div>Adverse effects of PN
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<ul class="circle"><li class="half_rhythm"><div>Hyperglycaemia</div></li><li class="half_rhythm"><div>Hypoglycaemia</div></li><li class="half_rhythm"><div>Hypertriglyceridemia</div></li><li class="half_rhythm"><div>Other PN associated liver disease</div></li></ul></div></li></ul>
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<b>Important</b>
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<ul><li class="half_rhythm"><div>Mortality</div></li><li class="half_rhythm"><div>Duration of hospital stay</div></li><li class="half_rhythm"><div>Nutritional intake (prescribed PN actually received)</div></li></ul></td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>*</dt><dd><div id="niceng154er2.tab1_1"><p class="no_margin">The decision was made not to specifically define the timeframe of ‘early’ or ‘late’ in the protocol because it was recognised that this could be interpreted as the ‘time from birth to starting PN’ or as ‘the time from birth to the decision to start PN’, which could take into account an initial trial of enteral feeding. This could lead to very different timings and would mean what definitions of ‘early’ in one study may be ‘late’ in another. The timing would therefore be extracted directly as reported in the studies and the details of this taken into consideration in the discussion.</p></div></dd></dl><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">PN: Parenteral nutrition</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng154er2tab2"><div id="niceng154er2.tab2" class="table"><h3><span class="label">Table 2</span><span class="title">Summary of included studies</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK555668/table/niceng154er2.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng154er2.tab2_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng154er2.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_niceng154er2.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><th id="hd_h_niceng154er2.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention</th><th id="hd_h_niceng154er2.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comparison</th><th id="hd_h_niceng154er2.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th></tr></thead><tbody><tr><td headers="hd_h_niceng154er2.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
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<a class="bibr" href="#niceng154er2.s1.ref1" rid="niceng154er2.s1.ref1">Brownlee 1993</a>
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</p>
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<p>RCT</p>
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<p>UK</p>
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</td><td headers="hd_h_niceng154er2.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>N=129</p>
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<p><u>Median GA</u> (range):</p>
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<p>Early: 29 weeks (23-33)</p>
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<p>Late: 29 weeks (24 – 36)</p>
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<p><u>Median BW</u> (range)</p>
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<p>Early: 1144g (539 – 1748)</p>
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<p>Late: 1147g (415 – 1647)</p>
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</td><td headers="hd_h_niceng154er2.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Early PN (n= 63)</p>
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<p>Received PN within the first 36 hours.</p>
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<p>PN followed standard regimen - 20% intralipid, 0.5 g/kg/day glucose (increased daily to 3.5 g/kg/day)</p>
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<p>Fluid regimen – started on 75ml/kg/day (increased to 165-180 ml.kg/day) of 10% dextrose solution</p>
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</td><td headers="hd_h_niceng154er2.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Late PN (n=66)</p>
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<p>Received PN on the sixth complete day</p>
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<p>PN followed standard regimen - 20% intralipid, 0.5 g/kg/day glucose (increased daily to 3.5 g/kg/day)</p>
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<p>Fluid regimen – started on 75ml/kg/day (increased to 165-180 ml.kg/day) of 10% dextrose solution</p>
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</td><td headers="hd_h_niceng154er2.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul><li class="half_rhythm"><div>Weight gain</div></li><li class="half_rhythm"><div>Mortality</div></li><li class="half_rhythm"><div>Nutrient intake</div></li></ul></td></tr><tr><td headers="hd_h_niceng154er2.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
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<a class="bibr" href="#niceng154er2.s1.ref2" rid="niceng154er2.s1.ref2">Dongming 2016</a>
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</p>
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<p>RCT</p>
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<p>China</p>
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</td><td headers="hd_h_niceng154er2.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>N=80</p>
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<p>
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<u>Mean age</u>
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</p>
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<p>Early: 30.3 weeks (SD 2.4)</p>
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<p>Late: 30.4 weeks (SD 2.2)</p>
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<p>
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<u>Mean BW</u>
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</p>
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<p>Early: 1140g (SD 220)</p>
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<p>Late: 1148g (SD 216)</p>
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</td><td headers="hd_h_niceng154er2.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Early PN (n=40)</p>
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<p>Received PN within the first 24 hours after birth with 20% fat emulsion and 6% amino acid, initial dose 1.5 g/kg/day, daily increments of 0.5 g/kg/day up to 3 g/kg/day</p>
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</td><td headers="hd_h_niceng154er2.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Late PN (n=40)</p>
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<p>Received PN within 3 days with 5-10% glucose</p>
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<p>After day 3 received the same intravenous nutrition as the early group.</p>
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</td><td headers="hd_h_niceng154er2.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul><li class="half_rhythm"><div>Proportion of body weight loss (%)</div></li><li class="half_rhythm"><div>Hyperglycaemia</div></li></ul></td></tr><tr><td headers="hd_h_niceng154er2.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
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<a class="bibr" href="#niceng154er2.s1.ref3" rid="niceng154er2.s1.ref3">Ibrahim 2004</a>
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</p>
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<p>RCT</p>
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<p>USA</p>
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</td><td headers="hd_h_niceng154er2.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>N=32</p>
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<p>
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<u>Mean GA</u>
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</p>
|
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<p>Early: 27 weeks (SD 1.6)</p>
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<p>Late: 26.8 weeks (SD 1.5)</p>
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<p>
|
|
<u>Mean BW</u>
|
|
</p>
|
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<p>Early: 846g (SD 261)</p>
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<p>Late: 968 (SD 244)</p>
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</td><td headers="hd_h_niceng154er2.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Early PN (n=16)</p>
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<p>Received PN within the first 2 hours after birth</p>
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<p>3.5g/kg/day AA, 3g/kg/day of 20% lipid</p>
|
|
</td><td headers="hd_h_niceng154er2.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Late PN (n=16)</p>
|
|
<p>Received a solution containing 5 to 10% glucose during the first 48 hours of life</p>
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<p>After 48 hours PN included 2g/kg/day AA and 0.5g/kg/day lipid. These increased to a maximum of 3.5g/kg/day and 3g/kg/day respectively</p>
|
|
</td><td headers="hd_h_niceng154er2.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<ul><li class="half_rhythm"><div>Calorie intake</div></li><li class="half_rhythm"><div>Mortality</div></li><li class="half_rhythm"><div>Sepsis</div></li></ul></td></tr><tr><td headers="hd_h_niceng154er2.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
|
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<a class="bibr" href="#niceng154er2.s1.ref4" rid="niceng154er2.s1.ref4">van Puffelen 2018</a>
|
|
</p>
|
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<p>RCT</p>
|
|
<p>Belgium, Canada & Netherlands</p>
|
|
</td><td headers="hd_h_niceng154er2.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<p>N=209</p>
|
|
<p>
|
|
<u>Mean GA</u>
|
|
</p>
|
|
<p>Early: 38.4 weeks (SD 1.4)</p>
|
|
<p>Late: 38.6 weeks (SD 1.6)</p>
|
|
<p>
|
|
<u>Mean BW</u>
|
|
</p>
|
|
<p>Early: 3193g (SD 538)</p>
|
|
<p>Late: 3238g (SD 510)</p>
|
|
</td><td headers="hd_h_niceng154er2.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<p>Early PN (n=98)</p>
|
|
<p>Received PN within 24 hours of admission</p>
|
|
</td><td headers="hd_h_niceng154er2.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<p>Late PN (n=111)</p>
|
|
<p>Received PN after 1 week</p>
|
|
</td><td headers="hd_h_niceng154er2.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul><li class="half_rhythm"><div>PICU acquired infections</div></li><li class="half_rhythm"><div>Hypoglycaemia</div></li><li class="half_rhythm"><div>Mortality</div></li></ul></td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">AA: Amino acid; BW: Birth weight; GA: Gestational age; VLBW: Very low birth weight; PICU: Paediatric intensive care unit; PN: Parenteral nutrition; RCT: Randomised controlled trail; SD Standard deviation.</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng154er2appatab1"><div id="niceng154er2.appa.tab1" class="table"><h3><span class="label">Table 3</span><span class="title">Review protocol – optimal timeframe to starting PN</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK555668/table/niceng154er2.appa.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng154er2.appa.tab1_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng154er2.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Field (based on <a href="http://www.prisma-statement.org/Extensions/Protocols.aspx" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">PRISMA-P</a>)</th><th id="hd_h_niceng154er2.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Content</th></tr></thead><tbody><tr><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Review question</td><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For those neonates where parenteral nutrition is required, what is the optimal timeframe for doing this?</td></tr><tr><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Type of review question</td><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention</td></tr><tr><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Objective of the review</td><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Where provision of parenteral nutrition (PN) support has been agreed, the optimal timeframe for starting such support is important.</td></tr><tr><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Eligibility criteria – population/disease/condition/issue/domain</td><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Where a decision has been made that PN is needed:</p>
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<p>Babies born preterm, up to 28 days after their due birth date (preterm babies)</p>
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<p>Babies born at term, up to 28 days after their birth (term babies).</p>
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</td></tr><tr><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Eligibility criteria – intervention(s)/exposure(s)/prognostic factor(s)</td><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Early start of PN</p>
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<p>The decision was made not to specifically define the timeframe of ‘early’ or ‘late’ in the protocol because it was recognised that this could be interpreted as the ‘time from birth to starting PN’ or as ‘the time from birth to the decision to start PN’, which could take into account an initial trial of enteral feeding. This could lead to very different timings and would mean what definitions of ‘early’ in one study may be ‘late’ in another. The timing would therefore be extracted directly as reported in the studies and the details of this taken into consideration in the discussion.</p>
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</td></tr><tr><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Eligibility criteria – comparator(s)/control or reference (gold) standard</td><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Late start of PN</td></tr><tr><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes and prioritisation</td><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><b>Critical</b>
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<ul><li class="half_rhythm"><div>Neurodevelopmental outcomes (general cognitive abilities at two years corrected age as measured by a validated scale)</div></li><li class="half_rhythm"><div>Growth:
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<ul class="circle"><li class="half_rhythm"><div>Weight gain (g/kg/d)</div></li><li class="half_rhythm"><div>Linear growth</div></li><li class="half_rhythm"><div>Head circumference (mm)</div></li><li class="half_rhythm"><div>Infection (including sepsis)</div></li><li class="half_rhythm"><div>Body composition (measured as</div></li><li class="half_rhythm"><div>lean mass, fat-free mass, fat mass,</div></li><li class="half_rhythm"><div>adipose tissue)</div></li></ul></div></li><li class="half_rhythm"><div>Adverse effects of PN
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<ul class="circle"><li class="half_rhythm"><div>Hyperglycaemia</div></li><li class="half_rhythm"><div>Hypoglycaemia</div></li><li class="half_rhythm"><div>Hypertriglyceridemia</div></li><li class="half_rhythm"><div>Other PN associated liver disease</div></li></ul></div></li></ul>
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<b>Important</b>
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<ul><li class="half_rhythm"><div>Mortality</div></li><li class="half_rhythm"><div>Duration of hospital stay</div></li><li class="half_rhythm"><div>Nutritional intake (prescribed PN actually received)</div></li></ul></td></tr><tr><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Eligibility criteria – study design</td><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Systematic reviews of RCTs</p>
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<p>RCTs</p>
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<p>Comparative cohort studies (only if RCTs unavailable or limited data to inform decision making). The decision to include comparative cohort studies will be determined for each parameter according to available RCT data</p>
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<p>Conference abstracts of RCTs will only be considered if no evidence is available from full published RCTs (if no evidence from RCTs or comparative cohort studies available and are recent i.e., in the last 2 years-authors will be contacted for further information).</p>
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</td></tr><tr><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Other inclusion exclusion criteria</td><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>No sample size restriction</p>
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<p>No date restriction</p>
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</td></tr><tr><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Proposed sensitivity/sub-group analysis, or meta-regression</td><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Stratified analysis</p>
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<p>Babies born preterm, up to 28 days after their due birth date (preterm babies)</p>
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<p>Babies born at term, up to 28 days after their birth (term babies)</p>
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<p>Babies who are critically ill or need surgery</p>
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<p>Where evidence exists, consideration will be given to the specific needs of population subgroups:</p>
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<p>Age of baby (first 2 weeks vs. later)</p>
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<p>Preterm (Extremely preterm <28 weeks GA; very preterm: 28-31 weeks GA; moderately preterm: 32-36 weeks GA)</p>
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<p>Birth weight: Low birth weight (< 2500g); very low birth weight (< 1500g) and extremely low birth weight (< 1000g)</p>
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<p>Possible equality considerations</p>
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<p>Mothers aged 17 or below</p>
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<p>Parents or carers whose first language is not English</p>
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<p>Parents or carers who have learning difficulties</p>
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<p>Important confounders (when comparative observational studies are included for interventional reviews):</p>
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<p>Age of baby (first 2 weeks vs. later)</p>
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<p>Preterm (Very early <28 weeks GA; 28-31 weeks GA; 32-36 weeks GA)</p>
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<p>Birth weight: Low birth weight (< 2500g); very low birth weight (< 1500g) and extremely low birth weight (< 1000g)</p>
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<p>Sex of baby</p>
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<p>Gestation</p>
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<p>Neurodevelopmental outcomes:</p>
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<p>Biological (sex, small for gestational age, ethnicity)</p>
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<p>Neonatal (PVL, IVH, infarct, sepsis, ROP, NEC, antenatal/postnatal steroids, BPD at 36 weeks)</p>
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<p>Social (SES, substance abuse, alcohol abuse, multiple pregnancy, chorioamnionitis, neglect, maternal age, maternal mental health disorder)</p>
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<p>Postnatal (epilepsy, age of establishing feeding)</p>
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<p>Secure venous access</p>
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</td></tr><tr><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Selection process – duplicate screening/selection/analysis</td><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Sifting, data extraction, appraisal of methodological quality and GRADE assessment will be performed by the systematic reviewer. Quality control will be performed by the senior systematic reviewer.</p>
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<p>A random sample of the references will be sifted by a second reviewer. This sample size will be 10% of the total, or 100 studies if the search identifies fewer than 1000 studies. All disagreements will be resolved by discussion between the two reviewers. The senior systematic reviewer or guideline lead will act as arbiter where necessary.</p>
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</td></tr><tr><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Data management (software)</td><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Pairwise meta-analyses, if possible, will be performed using Cochrane Review Manager (RevMan5).</p>
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<p>‘GRADEpro’ will be used to assess the quality of evidence for each outcome. Low income countries will be downgraded for indirectness.</p>
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<p>NGA STAR software will be used for generating bibliographies/citations, study sifting, data extraction and recording quality assessment using checklists (ROBIS (systematic reviews and meta-analyses); Cochrane risk of bias tool (RCTs or comparative cohort studies); Cochrane risk of bias tool (Non-randomised studies).</p>
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</td></tr><tr><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Information sources – databases and dates</td><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Sources to be searched: Medline, Medline In-Process, CCTR, CDSR, DARE, HTA, Embase.</p>
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<p>Limits (e.g. date, study design): All study designs. Apply standard animal/non-English language filters. No date limit.</p>
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<p>Supplementary search techniques: No supplementary search techniques were used.</p>
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<p>See <a href="#niceng154er2.appb">appendix B</a> for full strategies.</p>
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</td></tr><tr><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Identify if an update</td><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">This is not an update</td></tr><tr><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Author contacts</td><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Developer: The National Guideline Alliance</p>
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<p>
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<a href="https://www.nice.org.uk/guidance/indevelopment/gid-ng10037" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.nice.org<wbr style="display:inline-block"></wbr>​.uk/guidance/indevelopment/gid-ng10037</a>
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</p>
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</td></tr><tr><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Highlight if amendment to previous protocol</td><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see section 4.5 of <a href="https://www.nice.org.uk/article/pmg20/chapter/4-Developing-review-questions-and-planning-the-evidence-review#planning-the-evidence-review" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a> 2014.</td></tr><tr><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Search strategy – for one database</td><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see <a href="#niceng154er2.appb">appendix B</a>.</td></tr><tr><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Data collection process – forms/duplicate</td><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">A standardised evidence table format will be used, and published as <a href="#niceng154er2.appd">appendix D</a> (clinical evidence tables) or <a href="#niceng154er2.apph">H</a> (economic evidence tables).</td></tr><tr><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Data items – define all variables to be collected</td><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see <a href="#niceng154er2.appb">appendix B</a>.</td></tr><tr><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Methods for assessing bias at outcome/study level</td><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Standard study checklists were used to critically appraise individual studies. For details please see section 6.2 of <a href="https://www.nice.org.uk/article/pmg20/chapter/6-Reviewing-research-evidence#assessing-the-quality-of-the-evidence" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a> 2014.</p>
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<p>The risk of bias across all available evidence was evaluated for each outcome using an adaptation of the ‘Grading of Recommendations Assessment, Development and Evaluation (GRADE) toolbox’ developed by the international GRADE working group <a href="http://www.gradeworkinggroup.org/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">http://www<wbr style="display:inline-block"></wbr>​.gradeworkinggroup.org/</a></p>
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</td></tr><tr><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Criteria for quantitative synthesis (where suitable)</td><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see section 6.4 of <a href="https://www.nice.org.uk/article/pmg20/chapter/6-Reviewing-research-evidence#assessing-the-quality-of-the-evidence" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a> 2014.</td></tr><tr><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Methods for analysis – combining studies and exploring (in)consistency</td><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details of the methods please see <a href="/books/NBK555668/bin/niceng154er2_bm3.pdf">supplementary material C</a>.</td></tr><tr><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Meta-bias assessment – publication bias, selective reporting bias</td><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>For details please see section 6.2 of <a href="https://www.nice.org.uk/article/pmg20/chapter/6-Reviewing-research-evidence#assessing-the-quality-of-the-evidence" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a> 2014.</p>
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<p>If sufficient relevant RCT evidence is available, publication bias will be explored using RevMan software to examine funnel plots.</p>
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<p>Trial registries will be examined to identify missing evidence: Clinical <a href="http://trials.gov" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">trials<wbr style="display:inline-block"></wbr>​.gov</a>, NIHR Clinical Trials Gateway.</p>
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</td></tr><tr><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Assessment of confidence in cumulative evidence</td><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see sections 6.4 and 9.1 of <a href="https://www.nice.org.uk/article/pmg20/chapter/1-Introduction-and-overview" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a> 2014.</td></tr><tr><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Rationale/context – Current management</td><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see the introduction to the evidence review.</td></tr><tr><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Describe contributions of authors and guarantor</td><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>A multidisciplinary committee developed the guideline. The committee was convened by The National Guideline Alliance and chaired by Joe Fawke (Consultant Neonatologist and Honorary Senior Lecturer, University Hospitals Leicester NHS Trust), in line with section 3 of <a href="https://www.nice.org.uk/article/pmg20/chapter/1%20Introduction%20and%20overview" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a> 2014.</p>
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<p>Staff from The National Guideline Alliance, undertook systematic literature searches, appraised the evidence, conducted meta-analysis and cost-effectiveness analysis where appropriate, and drafted the guideline in collaboration with the committee. For details of the methods please see <a href="/books/NBK555668/bin/niceng154er2_bm3.pdf">supplementary material C</a>.</p>
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</td></tr><tr><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sources of funding/support</td><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The National Guideline Alliance is funded by NICE and hosted by The Royal College of Obstetricians and Gynaecologists</td></tr><tr><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Name of sponsor</td><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The National Guideline Alliance is funded by NICE and hosted by The Royal College of Obstetricians and Gynaecologists</td></tr><tr><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Roles of sponsor</td><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NICE funds the National Guideline Alliance to develop guidelines for those working in the NHS, public health, and social care in England</td></tr><tr><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">PROSPERO registration number</td><td headers="hd_h_niceng154er2.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">This review is not registered with PROSPERO</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">BPD: bronchopulmonary dysplasia; CCTR: Cochrane controlled trials register; CDSR: Cochrane database of systematic reviews; DARE: database of abstracts of reviews of effects; GA: Gestational age; GRADE: Grading of Recommendations Assessment, Development and Evaluation; HTA: health technology assessment; IVH: intraventricular haemorrhage; NEC: necrotising enterocolitis; NGA: National Guidelines Alliance; NHS: National Health Service; NICE: National Institute of Clinical Excellence; NIHR: National Institute for Health Research; NGA: National Guideline Alliance; NHS: National Health Service; PN: Parenteral nutrition; PROSPERO: International prospective register of systematic reviews; PVL: periventricular leukomalacia; RCT: randomised controlled trial; ROBIS; risk of bias in systematic reviews; ROP: retinopathy of prematurity; SES: socioeconomic status.</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng154er2appbtab1"><div id="niceng154er2.appb.tab1" class="table"><h3><span class="title">Databases: Medline; Medline EPub Ahead of Print; and Medline In-Process & Other Non-Indexed Citations</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK555668/table/niceng154er2.appb.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng154er2.appb.tab1_lrgtbl__"><table><thead><tr><th id="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#</th><th id="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Searches</th></tr></thead><tbody><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">INFANT, NEWBORN/</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(neonat$ or newborn$ or new-born$ or baby or babies).ti,ab.</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">PREMATURE BIRTH/</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">4</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((preterm$ or pre-term$ or prematur$ or pre-matur$) adj5 (birth? or born)).ab,ti.</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp INFANT, PREMATURE/</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">6</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((preterm$ or pre-term$ or prematur$ or pre-matur$) adj5 infan$).ti,ab.</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">7</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(pre#mie? or premie or premies).ti,ab.</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">8</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp INFANT, LOW BIRTH WEIGHT/</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">9</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(low adj3 birth adj3 weigh$ adj5 infan$).ti,ab.</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((LBW or VLBW) adj5 infan$).ti,ab.</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">11</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">INTENSIVE CARE, NEONATAL/</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">12</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">INTENSIVE CARE UNITS, NEONATAL/</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">13</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NICU?.ti,ab.</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">14</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/1-13</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((Initiat$ or Start$ or Introduc$ or begin$ or commenc$ or inaugurat$ or launch$ or instigat$ or establish$ or set$ up or timing or early or earlier or prompt$ or quick$ or speed$ or rapid$ or fast or delay$ or late? or wait$ or slow$ or postpon$ or put$ off or defer$ or push$ back or belated$) adj5 parenteral$).ti,ab.</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((Initiat$ or Start$ or Introduc$ or begin$ or commenc$ or inaugurat$ or launch$ or instigat$ or establish$ or set$ up or timing or early or earlier or prompt$ or quick$ or speed$ or rapid$ or fast or delay$ or late? or wait$ or slow$ or postpon$ or put$ off or defer$ or push$ back or belated$) and parenteral$).ti.</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">17</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((Initiat$ or Start$ or Introduc$ or begin$ or commenc$ or inaugurat$ or launch$ or instigat$ or establish$ or set$ up or timing or early or earlier or prompt$ or quick$ or speed$ or rapid$ or fast or delay$ or late? or wait$ or slow$ or postpon$ or put$ off or defer$ or push$ back or belated$) adj5 (PN or SPN or IPN or TPN or STD-PN or IND-PN)).ti,ab.</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((Initiat$ or Start$ or Introduc$ or begin$ or commenc$ or inaugurat$ or launch$ or instigat$ or establish$ or set$ up or timing or early or earlier or prompt$ or quick$ or speed$ or rapid$ or fast or delay$ or late? or wait$ or slow$ or postpon$ or put$ off or defer$ or push$ back or belated$) adj5 (intravenous$ or intra-venous$ or IV or venous$ or infusion?) adj5 (nutrition$ or feed$ or fed$)).ti,ab.</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">19</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((Initiat$ or Start$ or Introduc$ or begin$ or commenc$ or inaugurat$ or launch$ or instigat$ or establish$ or set$ up or timing or early or earlier or prompt$ or quick$ or speed$ or rapid$ or fast or delay$ or late? or wait$ or slow$ or postpon$ or put$ off or defer$ or push$ back or belated$) and (intravenous$ or intra-venous$ or IV or venous$ or infusion?) and (nutrition$ or feed$ or fed$)).ti.</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">20</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((24 h$ or 24h$) adj5 parenteral$).ti,ab.</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">21</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/15-20</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">22</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">*PARENTERAL NUTRITION/</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">23</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">*PARENTERAL NUTRITION, TOTAL/</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">24</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">*PARENTERAL NUTRITION SOLUTIONS/</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">25</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/22-24</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">26</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">TIME FACTORS/</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">27</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(Initiat$ or Start$ or Introduc$ or begin$ or commenc$ or inaugurat$ or launch$ or instigat$ or establish$ or set$ up or timing or early or earlier or prompt$ or quick$ or speed$ or rapid$ or fast or delay$ or late? or wait$ or slow$ or postpon$ or put$ off or defer$ or push$ back or belated$).ti.</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">28</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">14 and 21</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">29</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">14 and 25 and 26</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">30</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">14 and 25 and 27</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">31</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/28-30</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">32</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">limit 31 to english language</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">33</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">LETTER/</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">34</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">EDITORIAL/</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">35</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NEWS/</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">36</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp HISTORICAL ARTICLE/</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">37</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">ANECDOTES AS TOPIC/</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">38</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">COMMENT/</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">39</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">CASE REPORT/</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">40</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(letter or comment*).ti.</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">41</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/33-40</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">42</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RANDOMIZED CONTROLLED TRIAL/ or random*.ti,ab.</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">43</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">41 not 42</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">44</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">ANIMALS/ not HUMANS/</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">45</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp ANIMALS, LABORATORY/</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">46</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp ANIMAL EXPERIMENTATION/</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">47</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp MODELS, ANIMAL/</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">48</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp RODENTIA/</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">49</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(rat or rats or mouse or mice).ti.</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">50</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/43-49</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">51</td><td headers="hd_h_niceng154er2.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">32 not 50</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng154er2appbtab2"><div id="niceng154er2.appb.tab2" class="table"><h3><span class="title">Databases: Embase; and Embase Classic</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK555668/table/niceng154er2.appb.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng154er2.appb.tab2_lrgtbl__"><table><thead><tr><th id="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#</th><th id="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Searches</th></tr></thead><tbody><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NEWBORN/</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(neonat$ or newborn$ or new-born$ or baby or babies).ti,ab.</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">PREMATURITY/</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">4</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((preterm$ or pre-term$ or prematur$ or pre-matur$) adj5 (birth? or born)).ab,ti.</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((preterm$ or pre-term$ or prematur$ or pre-matur$) adj5 infan$).ti,ab.</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">6</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(pre#mie? or premie or premies).ti,ab.</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">7</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp LOW BIRTH WEIGHT/</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">8</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(low adj3 birth adj3 weigh$ adj5 infan$).ti,ab.</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">9</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((LBW or VLBW) adj5 infan$).ti,ab.</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NEWBORN INTENSIVE CARE/</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">11</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NEONATAL INTENSIVE CARE UNIT/</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">12</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NICU?.ti,ab.</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">13</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/1-12</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">14</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((Initiat$ or Start$ or Introduc$ or begin$ or commenc$ or inaugurat$ or launch$ or instigat$ or establish$ or set$ up or timing or early or earlier or prompt$ or quick$ or speed$ or rapid$ or fast or delay$ or late? or wait$ or slow$ or postpon$ or put$ off or defer$ or push$ back or belated$) adj5 parenteral$).ti,ab.</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((Initiat$ or Start$ or Introduc$ or begin$ or commenc$ or inaugurat$ or launch$ or instigat$ or establish$ or set$ up or timing or early or earlier or prompt$ or quick$ or speed$ or rapid$ or fast or delay$ or late? or wait$ or slow$ or postpon$ or put$ off or defer$ or push$ back or belated$) and parenteral$).ti.</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((Initiat$ or Start$ or Introduc$ or begin$ or commenc$ or inaugurat$ or launch$ or instigat$ or establish$ or set$ up or timing or early or earlier or prompt$ or quick$ or speed$ or rapid$ or fast or delay$ or late? or wait$ or slow$ or postpon$ or put$ off or defer$ or push$ back or belated$) adj5 (PN or SPN or IPN or TPN or STD-PN or IND-PN)).ti,ab.</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">17</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((Initiat$ or Start$ or Introduc$ or begin$ or commenc$ or inaugurat$ or launch$ or instigat$ or establish$ or set$ up or timing or early or earlier or prompt$ or quick$ or speed$ or rapid$ or fast or delay$ or late? or wait$ or slow$ or postpon$ or put$ off or defer$ or push$ back or belated$) adj5 (intravenous$ or intra-venous$ or IV or venous$ or infusion?) adj5 (nutrition$ or feed$ or fed$)).ti,ab.</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((Initiat$ or Start$ or Introduc$ or begin$ or commenc$ or inaugurat$ or launch$ or instigat$ or establish$ or set$ up or timing or early or earlier or prompt$ or quick$ or speed$ or rapid$ or fast or delay$ or late? or wait$ or slow$ or postpon$ or put$ off or defer$ or push$ back or belated$) and (intravenous$ or intra-venous$ or IV or venous$ or infusion?) and (nutrition$ or feed$ or fed$)).ti.</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">19</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((24 h$ or 24h$) adj5 parenteral$).ti,ab.</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">20</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/14-19</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">21</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">*PARENTERAL NUTRITION/</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">22</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">*TOTAL PARENTERAL NUTRITION/</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">23</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">PERIPHERAL PARENTERAL NUTRITION/</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">24</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">PARENTERAL SOLUTIONS/</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">25</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">INTRAVENOUS FEEDING/</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">26</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/21-25</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">27</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">TIME FACTOR/</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">28</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(Initiat$ or Start$ or Introduc$ or begin$ or commenc$ or inaugurat$ or launch$ or instigat$ or establish$ or set$ up or timing or early or earlier or prompt$ or quick$ or speed$ or rapid$ or fast or delay$ or late? or wait$ or slow$ or postpon$ or put$ off or defer$ or push$ back or belated$).ti.</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">29</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">13 and 20</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">30</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">13 and 26 and 27</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">31</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">13 and 26 and 28</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">32</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/29-31</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">33</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">limit 32 to english language</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">34</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">letter.pt. or LETTER/</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">35</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">note.pt.</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">36</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">editorial.pt.</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">37</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">CASE REPORT/ or CASE STUDY/</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">38</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(letter or comment*).ti.</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">39</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/34-38</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">40</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RANDOMIZED CONTROLLED TRIAL/ or random*.ti,ab.</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">41</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">39 not 40</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">42</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">ANIMAL/ not HUMAN/</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">43</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NONHUMAN/</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">44</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp ANIMAL EXPERIMENT/</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">45</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp EXPERIMENTAL ANIMAL/</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">46</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">ANIMAL MODEL/</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">47</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp RODENT/</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">48</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(rat or rats or mouse or mice).ti.</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">49</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/41-48</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">50</td><td headers="hd_h_niceng154er2.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">33 not 49</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng154er2appbtab3"><div id="niceng154er2.appb.tab3" class="table"><h3><span class="title">Databases: Cochrane Central Register of Controlled Trials; Cochrane Database of Systematic Reviews; Database of Abstracts of Reviews of Effects; and Health Technology Assessment</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK555668/table/niceng154er2.appb.tab3/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng154er2.appb.tab3_lrgtbl__"><table><thead><tr><th id="hd_h_niceng154er2.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#</th><th id="hd_h_niceng154er2.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Searches</th></tr></thead><tbody><tr><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [INFANT, NEWBORN] this term only</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2</td><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(neonat* or newborn* or new-born* or baby or babies):ti,ab</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3</td><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [PREMATURE BIRTH] this term only</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">4</td><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((preterm* or pre-term* or prematur* or pre-matur*) near/5 (birth? or born)).ab,ti.</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5</td><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [INFANT, PREMATURE/</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">6</td><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((preterm* or pre-term* or prematur* or pre-matur*) near/5 infan*):ti,ab</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">7</td><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(pre#mie? or premie or premies):ti,ab</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">8</td><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [INFANT, LOW BIRTH WEIGHT/</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">9</td><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(low near/3 birth near/3 weigh* near/5 infan*):ti,ab</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10</td><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((LBW or VLBW) near/5 infan*):ti,ab</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">11</td><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [INTENSIVE CARE, NEONATAL] this term only</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">12</td><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [INTENSIVE CARE UNITS, NEONATAL] this term only</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">13</td><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NICU?:ti,ab</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">14</td><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#1 or #2 or #3 or #4 or #5 or #6 or #7 or #8 or #9 or #10 or #11 or #12 or #13</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15</td><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((Initiat* or Start* or Introduc* or begin* or commenc* or inaugurat* or launch* or instigat* or establish* or set* up or timing or early or earlier or prompt* or quick* or speed* or rapid* or fast or delay* or late? or wait* or slow* or postpon* or put* off or defer* or push* back or belated*) near/5 parenteral*):ti,ab</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16</td><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((Initiat* or Start* or Introduc* or begin* or commenc* or inaugurat* or launch* or instigat* or establish* or set* up or timing or early or earlier or prompt* or quick* or speed* or rapid* or fast or delay* or late? or wait* or slow* or postpon* or put* off or defer* or push* back or belated*) near/10 parenteral*).ti.</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">17</td><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((Initiat* or Start* or Introduc* or begin* or commenc* or inaugurat* or launch* or instigat* or establish* or set* up or timing or early or earlier or prompt* or quick* or speed* or rapid* or fast or delay* or late? or wait* or slow* or postpon* or put* off or defer* or push* back or belated*) near/5 (PN or SPN or IPN or TPN or STD-PN or IND-PN)):ti,ab</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18</td><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((Initiat* or Start* or Introduc* or begin* or commenc* or inaugurat* or launch* or instigat* or establish* or set* up or timing or early or earlier or prompt* or quick* or speed* or rapid* or fast or delay* or late? or wait* or slow* or postpon* or put* off or defer* or push* back or belated*) near/5 (intravenous* or intra-venous* or IV or venous* or infusion?) near/5 (nutrition* or feed* or fed*)):ti,ab</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">19</td><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((Initiat* or Start* or Introduc* or begin* or commenc* or inaugurat* or launch* or instigat* or establish* or set* up or timing or early or earlier or prompt* or quick* or speed* or rapid* or fast or delay* or late? or wait* or slow* or postpon* or put* off or defer* or push* back or belated*) near/10 (intravenous* or intra-venous* or IV or venous* or infusion?) near/10 (nutrition* or feed* or fed*)).ti.</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">20</td><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((24 h* or 24h*) near/5 parenteral*):ti,ab</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">21</td><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#15 or #16 or #17 or #18 or #19 or #20</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">22</td><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [PARENTERAL NUTRITION] this term only</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">23</td><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [PARENTERAL NUTRITION, TOTAL] this term only</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">24</td><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [PARENTERAL NUTRITION SOLUTIONS] this term only</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">25</td><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#22 or #23 or #24</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">26</td><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [TIME FACTORS] this term only</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">27</td><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(Initiat* or Start* or Introduc* or begin* or commenc* or inaugurat* or launch* or instigat* or establish* or set* up or timing or early or earlier or prompt* or quick* or speed* or rapid* or fast or delay* or late? or wait* or slow* or postpon* or put* off or defer* or push* back or belated*).ti.</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">28</td><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#14 and #21</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">29</td><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#14 and #25 and #26</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">30</td><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#14 and #25 and #27</td></tr><tr><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">31</td><td headers="hd_h_niceng154er2.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#28 or #29 or #30</td></tr></tbody></table></div></div></article><article data-type="fig" id="figobniceng154er2appcfig1"><div id="niceng154er2.appc.fig1" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%201.%20PRISMA%20Flow%20chart%20of%20clinical%20article%20selection%20for%20review%20question%2C%20for%20those%20neonates%20where%20PN%20is%20required%2C%20what%20is%20the%20optimal%20timeframe%3F&p=BOOKS&id=555668_niceng154er2appcf1.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK555668/bin/niceng154er2appcf1.jpg" alt="Figure 1. PRISMA Flow chart of clinical article selection for review question, for those neonates where PN is required, what is the optimal timeframe?" class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 1</span><span class="title">PRISMA Flow chart of clinical article selection for review question, for those neonates where PN is required, what is the optimal timeframe?</span></h3></div></article><article data-type="table-wrap" id="figobniceng154er2appftab1"><div id="niceng154er2.appf.tab1" class="table"><h3><span class="label">Table 5</span><span class="title">Clinical evidence profile for early versus late delivery of parenteral nutrition in preterm babies</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK555668/table/niceng154er2.appf.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng154er2.appf.tab1_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng154er2.appf.tab1_1_1_1_1" colspan="7" rowspan="1" style="text-align:left;vertical-align:bottom;">Quality assessment</th><th id="hd_h_niceng154er2.appf.tab1_1_1_1_2" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">No of patients</th><th id="hd_h_niceng154er2.appf.tab1_1_1_1_3" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Effect</th><th id="hd_h_niceng154er2.appf.tab1_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng154er2.appf.tab1_1_1_1_4" style="text-align:left;vertical-align:bottom;">Quality</th><th id="hd_h_niceng154er2.appf.tab1_1_1_1_5" rowspan="2" colspan="1" headers="hd_h_niceng154er2.appf.tab1_1_1_1_5" style="text-align:left;vertical-align:bottom;">Importance</th></tr><tr><th headers="hd_h_niceng154er2.appf.tab1_1_1_1_1" id="hd_h_niceng154er2.appf.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No of studies</th><th headers="hd_h_niceng154er2.appf.tab1_1_1_1_1" id="hd_h_niceng154er2.appf.tab1_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Design</th><th headers="hd_h_niceng154er2.appf.tab1_1_1_1_1" id="hd_h_niceng154er2.appf.tab1_1_1_2_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Risk of bias</th><th headers="hd_h_niceng154er2.appf.tab1_1_1_1_1" id="hd_h_niceng154er2.appf.tab1_1_1_2_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Inconsistency</th><th headers="hd_h_niceng154er2.appf.tab1_1_1_1_1" id="hd_h_niceng154er2.appf.tab1_1_1_2_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Indirectness</th><th headers="hd_h_niceng154er2.appf.tab1_1_1_1_1" id="hd_h_niceng154er2.appf.tab1_1_1_2_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Imprecision</th><th headers="hd_h_niceng154er2.appf.tab1_1_1_1_1" id="hd_h_niceng154er2.appf.tab1_1_1_2_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Other considerations</th><th headers="hd_h_niceng154er2.appf.tab1_1_1_1_2" id="hd_h_niceng154er2.appf.tab1_1_1_2_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Early PN</th><th headers="hd_h_niceng154er2.appf.tab1_1_1_1_2" id="hd_h_niceng154er2.appf.tab1_1_1_2_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Late PN</th><th headers="hd_h_niceng154er2.appf.tab1_1_1_1_3" id="hd_h_niceng154er2.appf.tab1_1_1_2_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Relative (95% CI)</th><th headers="hd_h_niceng154er2.appf.tab1_1_1_1_3" id="hd_h_niceng154er2.appf.tab1_1_1_2_11" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Absolute</th></tr></thead><tbody><tr><th headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_1 hd_h_niceng154er2.appf.tab1_1_1_2_2 hd_h_niceng154er2.appf.tab1_1_1_2_3 hd_h_niceng154er2.appf.tab1_1_1_2_4 hd_h_niceng154er2.appf.tab1_1_1_2_5 hd_h_niceng154er2.appf.tab1_1_1_2_6 hd_h_niceng154er2.appf.tab1_1_1_2_7 hd_h_niceng154er2.appf.tab1_1_1_1_2 hd_h_niceng154er2.appf.tab1_1_1_2_8 hd_h_niceng154er2.appf.tab1_1_1_2_9 hd_h_niceng154er2.appf.tab1_1_1_1_3 hd_h_niceng154er2.appf.tab1_1_1_2_10 hd_h_niceng154er2.appf.tab1_1_1_2_11 hd_h_niceng154er2.appf.tab1_1_1_1_4 hd_h_niceng154er2.appf.tab1_1_1_1_5" id="hd_b_niceng154er2.appf.tab1_1_1_1_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Weight gain at 2 weeks (g) (follow-up mean 2 weeks; Better indicated by higher values)</th></tr><tr><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_1 hd_b_niceng154er2.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_2 hd_b_niceng154er2.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_3 hd_b_niceng154er2.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>1</sup></td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_4 hd_b_niceng154er2.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_5 hd_b_niceng154er2.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_6 hd_b_niceng154er2.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>2</sup></td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_7 hd_b_niceng154er2.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_2 hd_h_niceng154er2.appf.tab1_1_1_2_8 hd_b_niceng154er2.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">63</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_2 hd_h_niceng154er2.appf.tab1_1_1_2_9 hd_b_niceng154er2.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">66</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_3 hd_h_niceng154er2.appf.tab1_1_1_2_10 hd_b_niceng154er2.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_3 hd_h_niceng154er2.appf.tab1_1_1_2_11 hd_b_niceng154er2.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD 13 higher (3.92 lower to 29.92 higher)</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_4 hd_b_niceng154er2.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>VERY LOW</p>
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</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_5 hd_b_niceng154er2.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">CRITICAL</td></tr><tr><th headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_1 hd_h_niceng154er2.appf.tab1_1_1_2_2 hd_h_niceng154er2.appf.tab1_1_1_2_3 hd_h_niceng154er2.appf.tab1_1_1_2_4 hd_h_niceng154er2.appf.tab1_1_1_2_5 hd_h_niceng154er2.appf.tab1_1_1_2_6 hd_h_niceng154er2.appf.tab1_1_1_2_7 hd_h_niceng154er2.appf.tab1_1_1_1_2 hd_h_niceng154er2.appf.tab1_1_1_2_8 hd_h_niceng154er2.appf.tab1_1_1_2_9 hd_h_niceng154er2.appf.tab1_1_1_1_3 hd_h_niceng154er2.appf.tab1_1_1_2_10 hd_h_niceng154er2.appf.tab1_1_1_2_11 hd_h_niceng154er2.appf.tab1_1_1_1_4 hd_h_niceng154er2.appf.tab1_1_1_1_5" id="hd_b_niceng154er2.appf.tab1_1_1_3_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Weight gain per day to discharge (Better indicated by higher values)</th></tr><tr><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_1 hd_b_niceng154er2.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_2 hd_b_niceng154er2.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_3 hd_b_niceng154er2.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>1</sup></td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_4 hd_b_niceng154er2.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_5 hd_b_niceng154er2.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_6 hd_b_niceng154er2.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>3</sup></td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_7 hd_b_niceng154er2.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_2 hd_h_niceng154er2.appf.tab1_1_1_2_8 hd_b_niceng154er2.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">63</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_2 hd_h_niceng154er2.appf.tab1_1_1_2_9 hd_b_niceng154er2.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">66</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_3 hd_h_niceng154er2.appf.tab1_1_1_2_10 hd_b_niceng154er2.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_3 hd_h_niceng154er2.appf.tab1_1_1_2_11 hd_b_niceng154er2.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD 2.4 lower (5.3 lower to 0.5 higher)</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_4 hd_b_niceng154er2.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>VERY LOW</p>
|
|
</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_5 hd_b_niceng154er2.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">CRITICAL</td></tr><tr><th headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_1 hd_h_niceng154er2.appf.tab1_1_1_2_2 hd_h_niceng154er2.appf.tab1_1_1_2_3 hd_h_niceng154er2.appf.tab1_1_1_2_4 hd_h_niceng154er2.appf.tab1_1_1_2_5 hd_h_niceng154er2.appf.tab1_1_1_2_6 hd_h_niceng154er2.appf.tab1_1_1_2_7 hd_h_niceng154er2.appf.tab1_1_1_1_2 hd_h_niceng154er2.appf.tab1_1_1_2_8 hd_h_niceng154er2.appf.tab1_1_1_2_9 hd_h_niceng154er2.appf.tab1_1_1_1_3 hd_h_niceng154er2.appf.tab1_1_1_2_10 hd_h_niceng154er2.appf.tab1_1_1_2_11 hd_h_niceng154er2.appf.tab1_1_1_1_4 hd_h_niceng154er2.appf.tab1_1_1_1_5" id="hd_b_niceng154er2.appf.tab1_1_1_5_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Hyperglycaemia</th></tr><tr><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_1 hd_b_niceng154er2.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_2 hd_b_niceng154er2.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_3 hd_b_niceng154er2.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>1</sup></td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_4 hd_b_niceng154er2.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_5 hd_b_niceng154er2.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_6 hd_b_niceng154er2.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>4</sup></td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_7 hd_b_niceng154er2.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_2 hd_h_niceng154er2.appf.tab1_1_1_2_8 hd_b_niceng154er2.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<p>1/40</p>
|
|
<p>(2.5%)</p>
|
|
</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_2 hd_h_niceng154er2.appf.tab1_1_1_2_9 hd_b_niceng154er2.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>3/40</p>
|
|
<p>(7.5%)</p>
|
|
</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_3 hd_h_niceng154er2.appf.tab1_1_1_2_10 hd_b_niceng154er2.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RR 0.33 (0.04 to 3.07)</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_3 hd_h_niceng154er2.appf.tab1_1_1_2_11 hd_b_niceng154er2.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">50 fewer per 1000 (from 72 fewer to 155 more)</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_4 hd_b_niceng154er2.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>VERY LOW</p>
|
|
</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_5 hd_b_niceng154er2.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">CRITICAL</td></tr><tr><th headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_1 hd_h_niceng154er2.appf.tab1_1_1_2_2 hd_h_niceng154er2.appf.tab1_1_1_2_3 hd_h_niceng154er2.appf.tab1_1_1_2_4 hd_h_niceng154er2.appf.tab1_1_1_2_5 hd_h_niceng154er2.appf.tab1_1_1_2_6 hd_h_niceng154er2.appf.tab1_1_1_2_7 hd_h_niceng154er2.appf.tab1_1_1_1_2 hd_h_niceng154er2.appf.tab1_1_1_2_8 hd_h_niceng154er2.appf.tab1_1_1_2_9 hd_h_niceng154er2.appf.tab1_1_1_1_3 hd_h_niceng154er2.appf.tab1_1_1_2_10 hd_h_niceng154er2.appf.tab1_1_1_2_11 hd_h_niceng154er2.appf.tab1_1_1_1_4 hd_h_niceng154er2.appf.tab1_1_1_1_5" id="hd_b_niceng154er2.appf.tab1_1_1_7_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Sepsis</th></tr><tr><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_1 hd_b_niceng154er2.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_2 hd_b_niceng154er2.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_3 hd_b_niceng154er2.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>5</sup></td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_4 hd_b_niceng154er2.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_5 hd_b_niceng154er2.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_6 hd_b_niceng154er2.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>4</sup></td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_7 hd_b_niceng154er2.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_2 hd_h_niceng154er2.appf.tab1_1_1_2_8 hd_b_niceng154er2.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>6/14</p>
|
|
<p>(42.9%)</p>
|
|
</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_2 hd_h_niceng154er2.appf.tab1_1_1_2_9 hd_b_niceng154er2.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>7/15</p>
|
|
<p>(46.7%)</p>
|
|
</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_3 hd_h_niceng154er2.appf.tab1_1_1_2_10 hd_b_niceng154er2.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RR 0.92 (0.41 to 2.07)</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_3 hd_h_niceng154er2.appf.tab1_1_1_2_11 hd_b_niceng154er2.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">37 fewer per 1000 (from 275 fewer to 499 more)</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_4 hd_b_niceng154er2.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW</p>
|
|
</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_5 hd_b_niceng154er2.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">CRITICAL</td></tr><tr><th headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_1 hd_h_niceng154er2.appf.tab1_1_1_2_2 hd_h_niceng154er2.appf.tab1_1_1_2_3 hd_h_niceng154er2.appf.tab1_1_1_2_4 hd_h_niceng154er2.appf.tab1_1_1_2_5 hd_h_niceng154er2.appf.tab1_1_1_2_6 hd_h_niceng154er2.appf.tab1_1_1_2_7 hd_h_niceng154er2.appf.tab1_1_1_1_2 hd_h_niceng154er2.appf.tab1_1_1_2_8 hd_h_niceng154er2.appf.tab1_1_1_2_9 hd_h_niceng154er2.appf.tab1_1_1_1_3 hd_h_niceng154er2.appf.tab1_1_1_2_10 hd_h_niceng154er2.appf.tab1_1_1_2_11 hd_h_niceng154er2.appf.tab1_1_1_1_4 hd_h_niceng154er2.appf.tab1_1_1_1_5" id="hd_b_niceng154er2.appf.tab1_1_1_9_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Mortality - 36 hours versus 6 days (follow-up median 8 days)</th></tr><tr><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_1 hd_b_niceng154er2.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_2 hd_b_niceng154er2.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_3 hd_b_niceng154er2.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>1</sup></td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_4 hd_b_niceng154er2.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_5 hd_b_niceng154er2.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_6 hd_b_niceng154er2.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>4</sup></td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_7 hd_b_niceng154er2.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_2 hd_h_niceng154er2.appf.tab1_1_1_2_8 hd_b_niceng154er2.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>11/63</p>
|
|
<p>(17.5%)</p>
|
|
</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_2 hd_h_niceng154er2.appf.tab1_1_1_2_9 hd_b_niceng154er2.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>14/66</p>
|
|
<p>(21.2%)</p>
|
|
</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_3 hd_h_niceng154er2.appf.tab1_1_1_2_10 hd_b_niceng154er2.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RR 0.82 (0.4 to 1.67)</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_3 hd_h_niceng154er2.appf.tab1_1_1_2_11 hd_b_niceng154er2.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">38 fewer per 1000 (from 127 fewer to 142 more)</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_4 hd_b_niceng154er2.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW</p>
|
|
</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_5 hd_b_niceng154er2.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_1 hd_h_niceng154er2.appf.tab1_1_1_2_2 hd_h_niceng154er2.appf.tab1_1_1_2_3 hd_h_niceng154er2.appf.tab1_1_1_2_4 hd_h_niceng154er2.appf.tab1_1_1_2_5 hd_h_niceng154er2.appf.tab1_1_1_2_6 hd_h_niceng154er2.appf.tab1_1_1_2_7 hd_h_niceng154er2.appf.tab1_1_1_1_2 hd_h_niceng154er2.appf.tab1_1_1_2_8 hd_h_niceng154er2.appf.tab1_1_1_2_9 hd_h_niceng154er2.appf.tab1_1_1_1_3 hd_h_niceng154er2.appf.tab1_1_1_2_10 hd_h_niceng154er2.appf.tab1_1_1_2_11 hd_h_niceng154er2.appf.tab1_1_1_1_4 hd_h_niceng154er2.appf.tab1_1_1_1_5" id="hd_b_niceng154er2.appf.tab1_1_1_11_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Mortality - 2 hours versus 48 hours</th></tr><tr><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_1 hd_b_niceng154er2.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_2 hd_b_niceng154er2.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_3 hd_b_niceng154er2.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>5</sup></td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_4 hd_b_niceng154er2.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_5 hd_b_niceng154er2.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_6 hd_b_niceng154er2.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>4</sup></td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_7 hd_b_niceng154er2.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_2 hd_h_niceng154er2.appf.tab1_1_1_2_8 hd_b_niceng154er2.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1/16</p>
|
|
<p>(6.3%)</p>
|
|
</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_2 hd_h_niceng154er2.appf.tab1_1_1_2_9 hd_b_niceng154er2.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>2/16</p>
|
|
<p>(12.5%)</p>
|
|
</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_3 hd_h_niceng154er2.appf.tab1_1_1_2_10 hd_b_niceng154er2.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RR 0.5 (0.05 to 4.98)</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_3 hd_h_niceng154er2.appf.tab1_1_1_2_11 hd_b_niceng154er2.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">62 fewer per 1000 (from 119 fewer to 498 more)</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_4 hd_b_niceng154er2.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW</p>
|
|
</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_5 hd_b_niceng154er2.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_1 hd_h_niceng154er2.appf.tab1_1_1_2_2 hd_h_niceng154er2.appf.tab1_1_1_2_3 hd_h_niceng154er2.appf.tab1_1_1_2_4 hd_h_niceng154er2.appf.tab1_1_1_2_5 hd_h_niceng154er2.appf.tab1_1_1_2_6 hd_h_niceng154er2.appf.tab1_1_1_2_7 hd_h_niceng154er2.appf.tab1_1_1_1_2 hd_h_niceng154er2.appf.tab1_1_1_2_8 hd_h_niceng154er2.appf.tab1_1_1_2_9 hd_h_niceng154er2.appf.tab1_1_1_1_3 hd_h_niceng154er2.appf.tab1_1_1_2_10 hd_h_niceng154er2.appf.tab1_1_1_2_11 hd_h_niceng154er2.appf.tab1_1_1_1_4 hd_h_niceng154er2.appf.tab1_1_1_1_5" id="hd_b_niceng154er2.appf.tab1_1_1_13_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Caloric intake in first five days of life (kcal/kg/day) (follow-up mean 5 days; Better indicated by higher values)</th></tr><tr><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_1 hd_b_niceng154er2.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_2 hd_b_niceng154er2.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_3 hd_b_niceng154er2.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>5</sup></td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_4 hd_b_niceng154er2.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_5 hd_b_niceng154er2.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_6 hd_b_niceng154er2.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious imprecision</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_1 hd_h_niceng154er2.appf.tab1_1_1_2_7 hd_b_niceng154er2.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_2 hd_h_niceng154er2.appf.tab1_1_1_2_8 hd_b_niceng154er2.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_2 hd_h_niceng154er2.appf.tab1_1_1_2_9 hd_b_niceng154er2.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_3 hd_h_niceng154er2.appf.tab1_1_1_2_10 hd_b_niceng154er2.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_3 hd_h_niceng154er2.appf.tab1_1_1_2_11 hd_b_niceng154er2.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD 18.4 higher (17.22 to 19.58 higher)</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_4 hd_b_niceng154er2.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁⨁◯</p>
|
|
<p>MODERATE</p>
|
|
</td><td headers="hd_h_niceng154er2.appf.tab1_1_1_1_5 hd_b_niceng154er2.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">IMPORTANT</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">CI: confidence interval; PN: parenteral nutrition; RR: risk ratio.</p></div></dd></dl><dl class="bkr_refwrap"><dt>1</dt><dd><div id="niceng154er2.appf.tab1_1"><p class="no_margin">Very serious risk of bias, evidence downgraded due to unclear risk of allocation and selection bias. No details provided regarding methods of allocation or randomisation. Unclear risk of performance and detection bias, unclear if care personnel or assessors were blinded to treatment.</p></div></dd></dl><dl class="bkr_refwrap"><dt>2</dt><dd><div id="niceng154er2.appf.tab1_2"><p class="no_margin">Evidence was downgraded by 1 due to serious imprecision, 95% confidence interval crosses one default MID for continuous outcomes, calculated as 0.5 x SD control at baseline (24)</p></div></dd></dl><dl class="bkr_refwrap"><dt>3</dt><dd><div id="niceng154er2.appf.tab1_3"><p class="no_margin">Evidence was downgraded by 1 due to serious imprecision, 95% confidence interval crosses one default MID for continuous outcomes, calculated as 0.5 x SD control at baseline (4.6)</p></div></dd></dl><dl class="bkr_refwrap"><dt>4</dt><dd><div id="niceng154er2.appf.tab1_4"><p class="no_margin">Evidence was downgraded by 2 due to very serious imprecision, 95% confidence interval crosses two default MID for dichotomous outcomes, (0.8 and 1.25).</p></div></dd></dl><dl class="bkr_refwrap"><dt>5</dt><dd><div id="niceng154er2.appf.tab1_5"><p class="no_margin">Serious risk of bias, evidence downgraded due to unclear risk of selection bias, no details provided regarding methods of randomisation. Unclear risk of performance and detection bias, unclear if care personnel or assessors were blinded to treatment.</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng154er2appftab2"><div id="niceng154er2.appf.tab2" class="table"><h3><span class="label">Table 6</span><span class="title">Clinical evidence profile for early versus late parenteral nutrition in critically ill, term babies</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK555668/table/niceng154er2.appf.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng154er2.appf.tab2_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng154er2.appf.tab2_1_1_1_1" colspan="7" rowspan="1" style="text-align:left;vertical-align:bottom;">Quality assessment</th><th id="hd_h_niceng154er2.appf.tab2_1_1_1_2" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">No of patients</th><th id="hd_h_niceng154er2.appf.tab2_1_1_1_3" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Effect</th><th id="hd_h_niceng154er2.appf.tab2_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng154er2.appf.tab2_1_1_1_4" style="text-align:left;vertical-align:bottom;">Quality</th><th id="hd_h_niceng154er2.appf.tab2_1_1_1_5" rowspan="2" colspan="1" headers="hd_h_niceng154er2.appf.tab2_1_1_1_5" style="text-align:left;vertical-align:bottom;">Importance</th></tr><tr><th headers="hd_h_niceng154er2.appf.tab2_1_1_1_1" id="hd_h_niceng154er2.appf.tab2_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">No of studies</th><th headers="hd_h_niceng154er2.appf.tab2_1_1_1_1" id="hd_h_niceng154er2.appf.tab2_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Design</th><th headers="hd_h_niceng154er2.appf.tab2_1_1_1_1" id="hd_h_niceng154er2.appf.tab2_1_1_2_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk of bias</th><th headers="hd_h_niceng154er2.appf.tab2_1_1_1_1" id="hd_h_niceng154er2.appf.tab2_1_1_2_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Inconsistency</th><th headers="hd_h_niceng154er2.appf.tab2_1_1_1_1" id="hd_h_niceng154er2.appf.tab2_1_1_2_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Indirectness</th><th headers="hd_h_niceng154er2.appf.tab2_1_1_1_1" id="hd_h_niceng154er2.appf.tab2_1_1_2_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Imprecision</th><th headers="hd_h_niceng154er2.appf.tab2_1_1_1_1" id="hd_h_niceng154er2.appf.tab2_1_1_2_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Other considerations</th><th headers="hd_h_niceng154er2.appf.tab2_1_1_1_2" id="hd_h_niceng154er2.appf.tab2_1_1_2_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Early PN</th><th headers="hd_h_niceng154er2.appf.tab2_1_1_1_2" id="hd_h_niceng154er2.appf.tab2_1_1_2_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Late PN</th><th headers="hd_h_niceng154er2.appf.tab2_1_1_1_3" id="hd_h_niceng154er2.appf.tab2_1_1_2_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Relative (95% CI)</th><th headers="hd_h_niceng154er2.appf.tab2_1_1_1_3" id="hd_h_niceng154er2.appf.tab2_1_1_2_11" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Absolute</th></tr></thead><tbody><tr><th headers="hd_h_niceng154er2.appf.tab2_1_1_1_1 hd_h_niceng154er2.appf.tab2_1_1_2_1 hd_h_niceng154er2.appf.tab2_1_1_2_2 hd_h_niceng154er2.appf.tab2_1_1_2_3 hd_h_niceng154er2.appf.tab2_1_1_2_4 hd_h_niceng154er2.appf.tab2_1_1_2_5 hd_h_niceng154er2.appf.tab2_1_1_2_6 hd_h_niceng154er2.appf.tab2_1_1_2_7 hd_h_niceng154er2.appf.tab2_1_1_1_2 hd_h_niceng154er2.appf.tab2_1_1_2_8 hd_h_niceng154er2.appf.tab2_1_1_2_9 hd_h_niceng154er2.appf.tab2_1_1_1_3 hd_h_niceng154er2.appf.tab2_1_1_2_10 hd_h_niceng154er2.appf.tab2_1_1_2_11 hd_h_niceng154er2.appf.tab2_1_1_1_4 hd_h_niceng154er2.appf.tab2_1_1_1_5" id="hd_b_niceng154er2.appf.tab2_1_1_1_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">PICU acquired infection - whole sample</th></tr><tr><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_1 hd_h_niceng154er2.appf.tab2_1_1_2_1 hd_b_niceng154er2.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_1 hd_h_niceng154er2.appf.tab2_1_1_2_2 hd_b_niceng154er2.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_1 hd_h_niceng154er2.appf.tab2_1_1_2_3 hd_b_niceng154er2.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_1 hd_h_niceng154er2.appf.tab2_1_1_2_4 hd_b_niceng154er2.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_1 hd_h_niceng154er2.appf.tab2_1_1_2_5 hd_b_niceng154er2.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_1 hd_h_niceng154er2.appf.tab2_1_1_2_6 hd_b_niceng154er2.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>2</sup></td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_1 hd_h_niceng154er2.appf.tab2_1_1_2_7 hd_b_niceng154er2.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_2 hd_h_niceng154er2.appf.tab2_1_1_2_8 hd_b_niceng154er2.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>30/98</p>
|
|
<p>(30.6%)</p>
|
|
</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_2 hd_h_niceng154er2.appf.tab2_1_1_2_9 hd_b_niceng154er2.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<p>18/111</p>
|
|
<p>(16.2%)</p>
|
|
</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_3 hd_h_niceng154er2.appf.tab2_1_1_2_10 hd_b_niceng154er2.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RR 1.89 (1.13 to 3.17)</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_3 hd_h_niceng154er2.appf.tab2_1_1_2_11 hd_b_niceng154er2.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">144 more per 1000 (from 21 more to 352 more)</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_4 hd_b_niceng154er2.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
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<p>LOW</p>
|
|
</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_5 hd_b_niceng154er2.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">CRITICAL</td></tr><tr><th headers="hd_h_niceng154er2.appf.tab2_1_1_1_1 hd_h_niceng154er2.appf.tab2_1_1_2_1 hd_h_niceng154er2.appf.tab2_1_1_2_2 hd_h_niceng154er2.appf.tab2_1_1_2_3 hd_h_niceng154er2.appf.tab2_1_1_2_4 hd_h_niceng154er2.appf.tab2_1_1_2_5 hd_h_niceng154er2.appf.tab2_1_1_2_6 hd_h_niceng154er2.appf.tab2_1_1_2_7 hd_h_niceng154er2.appf.tab2_1_1_1_2 hd_h_niceng154er2.appf.tab2_1_1_2_8 hd_h_niceng154er2.appf.tab2_1_1_2_9 hd_h_niceng154er2.appf.tab2_1_1_1_3 hd_h_niceng154er2.appf.tab2_1_1_2_10 hd_h_niceng154er2.appf.tab2_1_1_2_11 hd_h_niceng154er2.appf.tab2_1_1_1_4 hd_h_niceng154er2.appf.tab2_1_1_1_5" id="hd_b_niceng154er2.appf.tab2_1_1_3_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">PICU acquired infection - no/minimal EN</th></tr><tr><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_1 hd_h_niceng154er2.appf.tab2_1_1_2_1 hd_b_niceng154er2.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_1 hd_h_niceng154er2.appf.tab2_1_1_2_2 hd_b_niceng154er2.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_1 hd_h_niceng154er2.appf.tab2_1_1_2_3 hd_b_niceng154er2.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_1 hd_h_niceng154er2.appf.tab2_1_1_2_4 hd_b_niceng154er2.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_1 hd_h_niceng154er2.appf.tab2_1_1_2_5 hd_b_niceng154er2.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_1 hd_h_niceng154er2.appf.tab2_1_1_2_6 hd_b_niceng154er2.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>2</sup></td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_1 hd_h_niceng154er2.appf.tab2_1_1_2_7 hd_b_niceng154er2.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_2 hd_h_niceng154er2.appf.tab2_1_1_2_8 hd_b_niceng154er2.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<p>16/23</p>
|
|
<p>(69.6%)</p>
|
|
</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_2 hd_h_niceng154er2.appf.tab2_1_1_2_9 hd_b_niceng154er2.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>7/15</p>
|
|
<p>(46.7%)</p>
|
|
</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_3 hd_h_niceng154er2.appf.tab2_1_1_2_10 hd_b_niceng154er2.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RR 1.49 (0.81 to 2.73)</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_3 hd_h_niceng154er2.appf.tab2_1_1_2_11 hd_b_niceng154er2.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">229 more per 1000 (from 89 fewer to 807 more)</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_4 hd_b_niceng154er2.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW</p>
|
|
</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_5 hd_b_niceng154er2.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">CRITICAL</td></tr><tr><th headers="hd_h_niceng154er2.appf.tab2_1_1_1_1 hd_h_niceng154er2.appf.tab2_1_1_2_1 hd_h_niceng154er2.appf.tab2_1_1_2_2 hd_h_niceng154er2.appf.tab2_1_1_2_3 hd_h_niceng154er2.appf.tab2_1_1_2_4 hd_h_niceng154er2.appf.tab2_1_1_2_5 hd_h_niceng154er2.appf.tab2_1_1_2_6 hd_h_niceng154er2.appf.tab2_1_1_2_7 hd_h_niceng154er2.appf.tab2_1_1_1_2 hd_h_niceng154er2.appf.tab2_1_1_2_8 hd_h_niceng154er2.appf.tab2_1_1_2_9 hd_h_niceng154er2.appf.tab2_1_1_1_3 hd_h_niceng154er2.appf.tab2_1_1_2_10 hd_h_niceng154er2.appf.tab2_1_1_2_11 hd_h_niceng154er2.appf.tab2_1_1_1_4 hd_h_niceng154er2.appf.tab2_1_1_1_5" id="hd_b_niceng154er2.appf.tab2_1_1_5_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Hypoglycaemia in first week - whole sample</th></tr><tr><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_1 hd_h_niceng154er2.appf.tab2_1_1_2_1 hd_b_niceng154er2.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_1 hd_h_niceng154er2.appf.tab2_1_1_2_2 hd_b_niceng154er2.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_1 hd_h_niceng154er2.appf.tab2_1_1_2_3 hd_b_niceng154er2.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_1 hd_h_niceng154er2.appf.tab2_1_1_2_4 hd_b_niceng154er2.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_1 hd_h_niceng154er2.appf.tab2_1_1_2_5 hd_b_niceng154er2.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_1 hd_h_niceng154er2.appf.tab2_1_1_2_6 hd_b_niceng154er2.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>2</sup></td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_1 hd_h_niceng154er2.appf.tab2_1_1_2_7 hd_b_niceng154er2.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_2 hd_h_niceng154er2.appf.tab2_1_1_2_8 hd_b_niceng154er2.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>14/98</p>
|
|
<p>(14.3%)</p>
|
|
</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_2 hd_h_niceng154er2.appf.tab2_1_1_2_9 hd_b_niceng154er2.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>26/111</p>
|
|
<p>(23.4%)</p>
|
|
</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_3 hd_h_niceng154er2.appf.tab2_1_1_2_10 hd_b_niceng154er2.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RR 0.61 (0.34 to 1.1)</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_3 hd_h_niceng154er2.appf.tab2_1_1_2_11 hd_b_niceng154er2.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">91 fewer per 1000 (from 155 fewer to 23 more)</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_4 hd_b_niceng154er2.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW</p>
|
|
</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_5 hd_b_niceng154er2.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">CRITICAL</td></tr><tr><th headers="hd_h_niceng154er2.appf.tab2_1_1_1_1 hd_h_niceng154er2.appf.tab2_1_1_2_1 hd_h_niceng154er2.appf.tab2_1_1_2_2 hd_h_niceng154er2.appf.tab2_1_1_2_3 hd_h_niceng154er2.appf.tab2_1_1_2_4 hd_h_niceng154er2.appf.tab2_1_1_2_5 hd_h_niceng154er2.appf.tab2_1_1_2_6 hd_h_niceng154er2.appf.tab2_1_1_2_7 hd_h_niceng154er2.appf.tab2_1_1_1_2 hd_h_niceng154er2.appf.tab2_1_1_2_8 hd_h_niceng154er2.appf.tab2_1_1_2_9 hd_h_niceng154er2.appf.tab2_1_1_1_3 hd_h_niceng154er2.appf.tab2_1_1_2_10 hd_h_niceng154er2.appf.tab2_1_1_2_11 hd_h_niceng154er2.appf.tab2_1_1_1_4 hd_h_niceng154er2.appf.tab2_1_1_1_5" id="hd_b_niceng154er2.appf.tab2_1_1_7_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Hypoglycaemia in first week - no/minimal EN</th></tr><tr><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_1 hd_h_niceng154er2.appf.tab2_1_1_2_1 hd_b_niceng154er2.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_1 hd_h_niceng154er2.appf.tab2_1_1_2_2 hd_b_niceng154er2.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_1 hd_h_niceng154er2.appf.tab2_1_1_2_3 hd_b_niceng154er2.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_1 hd_h_niceng154er2.appf.tab2_1_1_2_4 hd_b_niceng154er2.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_1 hd_h_niceng154er2.appf.tab2_1_1_2_5 hd_b_niceng154er2.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_1 hd_h_niceng154er2.appf.tab2_1_1_2_6 hd_b_niceng154er2.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>2</sup></td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_1 hd_h_niceng154er2.appf.tab2_1_1_2_7 hd_b_niceng154er2.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_2 hd_h_niceng154er2.appf.tab2_1_1_2_8 hd_b_niceng154er2.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>4/23</p>
|
|
<p>(17.4%)</p>
|
|
</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_2 hd_h_niceng154er2.appf.tab2_1_1_2_9 hd_b_niceng154er2.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>8/15</p>
|
|
<p>(53.3%)</p>
|
|
</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_3 hd_h_niceng154er2.appf.tab2_1_1_2_10 hd_b_niceng154er2.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RR 0.33 (0.12 to 0.89)</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_3 hd_h_niceng154er2.appf.tab2_1_1_2_11 hd_b_niceng154er2.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">357 fewer per 1000 (from 59 fewer to 469 fewer)</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_4 hd_b_niceng154er2.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW</p>
|
|
</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_5 hd_b_niceng154er2.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">CRITICAL</td></tr><tr><th headers="hd_h_niceng154er2.appf.tab2_1_1_1_1 hd_h_niceng154er2.appf.tab2_1_1_2_1 hd_h_niceng154er2.appf.tab2_1_1_2_2 hd_h_niceng154er2.appf.tab2_1_1_2_3 hd_h_niceng154er2.appf.tab2_1_1_2_4 hd_h_niceng154er2.appf.tab2_1_1_2_5 hd_h_niceng154er2.appf.tab2_1_1_2_6 hd_h_niceng154er2.appf.tab2_1_1_2_7 hd_h_niceng154er2.appf.tab2_1_1_1_2 hd_h_niceng154er2.appf.tab2_1_1_2_8 hd_h_niceng154er2.appf.tab2_1_1_2_9 hd_h_niceng154er2.appf.tab2_1_1_1_3 hd_h_niceng154er2.appf.tab2_1_1_2_10 hd_h_niceng154er2.appf.tab2_1_1_2_11 hd_h_niceng154er2.appf.tab2_1_1_1_4 hd_h_niceng154er2.appf.tab2_1_1_1_5" id="hd_b_niceng154er2.appf.tab2_1_1_9_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Mortality at 90 days - whole sample</th></tr><tr><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_1 hd_h_niceng154er2.appf.tab2_1_1_2_1 hd_b_niceng154er2.appf.tab2_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_1 hd_h_niceng154er2.appf.tab2_1_1_2_2 hd_b_niceng154er2.appf.tab2_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_1 hd_h_niceng154er2.appf.tab2_1_1_2_3 hd_b_niceng154er2.appf.tab2_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_1 hd_h_niceng154er2.appf.tab2_1_1_2_4 hd_b_niceng154er2.appf.tab2_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_1 hd_h_niceng154er2.appf.tab2_1_1_2_5 hd_b_niceng154er2.appf.tab2_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_1 hd_h_niceng154er2.appf.tab2_1_1_2_6 hd_b_niceng154er2.appf.tab2_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>2</sup></td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_1 hd_h_niceng154er2.appf.tab2_1_1_2_7 hd_b_niceng154er2.appf.tab2_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_2 hd_h_niceng154er2.appf.tab2_1_1_2_8 hd_b_niceng154er2.appf.tab2_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>15/98</p>
|
|
<p>(15.3%)</p>
|
|
</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_2 hd_h_niceng154er2.appf.tab2_1_1_2_9 hd_b_niceng154er2.appf.tab2_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>6/111</p>
|
|
<p>(5.4%)</p>
|
|
</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_3 hd_h_niceng154er2.appf.tab2_1_1_2_10 hd_b_niceng154er2.appf.tab2_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RR 2.83 (1.14 to 7.01)</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_3 hd_h_niceng154er2.appf.tab2_1_1_2_11 hd_b_niceng154er2.appf.tab2_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">99 more per 1000 (from 8 more to 325 more)</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_4 hd_b_niceng154er2.appf.tab2_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW</p>
|
|
</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_5 hd_b_niceng154er2.appf.tab2_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_niceng154er2.appf.tab2_1_1_1_1 hd_h_niceng154er2.appf.tab2_1_1_2_1 hd_h_niceng154er2.appf.tab2_1_1_2_2 hd_h_niceng154er2.appf.tab2_1_1_2_3 hd_h_niceng154er2.appf.tab2_1_1_2_4 hd_h_niceng154er2.appf.tab2_1_1_2_5 hd_h_niceng154er2.appf.tab2_1_1_2_6 hd_h_niceng154er2.appf.tab2_1_1_2_7 hd_h_niceng154er2.appf.tab2_1_1_1_2 hd_h_niceng154er2.appf.tab2_1_1_2_8 hd_h_niceng154er2.appf.tab2_1_1_2_9 hd_h_niceng154er2.appf.tab2_1_1_1_3 hd_h_niceng154er2.appf.tab2_1_1_2_10 hd_h_niceng154er2.appf.tab2_1_1_2_11 hd_h_niceng154er2.appf.tab2_1_1_1_4 hd_h_niceng154er2.appf.tab2_1_1_1_5" id="hd_b_niceng154er2.appf.tab2_1_1_11_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Mortality at 90 days - no/minimal EN</th></tr><tr><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_1 hd_h_niceng154er2.appf.tab2_1_1_2_1 hd_b_niceng154er2.appf.tab2_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_1 hd_h_niceng154er2.appf.tab2_1_1_2_2 hd_b_niceng154er2.appf.tab2_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_1 hd_h_niceng154er2.appf.tab2_1_1_2_3 hd_b_niceng154er2.appf.tab2_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_1 hd_h_niceng154er2.appf.tab2_1_1_2_4 hd_b_niceng154er2.appf.tab2_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_1 hd_h_niceng154er2.appf.tab2_1_1_2_5 hd_b_niceng154er2.appf.tab2_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_1 hd_h_niceng154er2.appf.tab2_1_1_2_6 hd_b_niceng154er2.appf.tab2_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>3</sup></td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_1 hd_h_niceng154er2.appf.tab2_1_1_2_7 hd_b_niceng154er2.appf.tab2_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_2 hd_h_niceng154er2.appf.tab2_1_1_2_8 hd_b_niceng154er2.appf.tab2_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>7/23</p>
|
|
<p>(30.4%)</p>
|
|
</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_2 hd_h_niceng154er2.appf.tab2_1_1_2_9 hd_b_niceng154er2.appf.tab2_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>2/15</p>
|
|
<p>(13.3%)</p>
|
|
</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_3 hd_h_niceng154er2.appf.tab2_1_1_2_10 hd_b_niceng154er2.appf.tab2_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RR 2.28 (0.55 to 9.54)</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_3 hd_h_niceng154er2.appf.tab2_1_1_2_11 hd_b_niceng154er2.appf.tab2_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">171 more per 1000 (from 60 fewer to 1000 more)</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_4 hd_b_niceng154er2.appf.tab2_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW</p>
|
|
</td><td headers="hd_h_niceng154er2.appf.tab2_1_1_1_5 hd_b_niceng154er2.appf.tab2_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">IMPORTANT</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">CI: confidence interval; EN: enteral nutrition; PICU: paediatric intensive care unit; PN: parenteral nutrition; RR: risk ratio.</p></div></dd></dl><dl class="bkr_refwrap"><dt>1</dt><dd><div id="niceng154er2.appf.tab2_1"><p class="no_margin">Serious risk of bias, evidence downgraded due to unclear risk of allocation concealment and performance bias.</p></div></dd></dl><dl class="bkr_refwrap"><dt>2</dt><dd><div id="niceng154er2.appf.tab2_2"><p class="no_margin">Evidence was downgraded by 1 due to serious imprecision, 95% confidence interval crosses one default MID for dichotomous outcomes, (0.8 or 1.25).</p></div></dd></dl><dl class="bkr_refwrap"><dt>3</dt><dd><div id="niceng154er2.appf.tab2_3"><p class="no_margin">Evidence was downgraded by 2 due to very serious imprecision, 95% confidence interval crosses two default MID for dichotomous outcomes, (0.8 and 1.25).</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng154er2appktab1"><div id="niceng154er2.appk.tab1" class="table"><h3><span class="label">Table 7</span><span class="title">Excluded studies and reasons for their exclusion</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK555668/table/niceng154er2.appk.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng154er2.appk.tab1_lrgtbl__"><table><thead><tr><th id="hd_h_niceng154er2.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_niceng154er2.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Reason for Exclusion</th></tr></thead><tbody><tr><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Abdou, R. M., Weheiba, H. M. I., The effect of early versus late lipid infusion in parenteral nutrition on the biochemical and cortical auditory evoked potential parameters in preterm neonates, Egyptian Pediatric Association Gazette, 2018
|
|
</td><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study intervention does not meet protocol eligibility criteria - early vs late lipids; infants receive glucose and dextrose from birth and amino acids from day 2.</td></tr><tr><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Aroor, Amitha R., Krishnan, Lalitha, Reyes, Zenaida, Fazallulah, Muhammed, Ahmed, Masood, Khan, Ashfaq A., Al-Farsi, Yahya, Early versus Late Parenteral Nutrition in Very Low Birthweight Neonates: A retrospective study from Oman, Sultan Qaboos University medical journal, 12, 33–40, 2012 [<a href="/pmc/articles/PMC3286714/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3286714</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/22375256" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22375256</span></a>]
|
|
</td><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not meet the inclusion criteria, this is a retrospective cohort study. Additionally, only AA are started early compared to late, all other constituents are given at the same time point.</td></tr><tr><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Bishay, M., Lakshminarayanan, B., Arnaud, A., Garriboli, M., Cross, K. M., Curry, J. I., Drake, D., Kiely, E. M., De Coppi, P., Pierro, A., Eaton, S., The role of parenteral nutrition following surgery for duodenal atresia or stenosis, Pediatric Surgery International, 29, 191–5, 2013 [<a href="https://pubmed.ncbi.nlm.nih.gov/23187894" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23187894</span></a>]
|
|
</td><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population does not meet the inclusion criteria.</td></tr><tr><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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Blanco, Cynthia Liudmilla, Falck, Alison, Green, Belinda Kay, Cornell, John E., Gong, Alice Kim, Metabolic responses to early and high protein supplementation in a randomized trial evaluating the prevention of hyperkalemia in extremely low birth weight infants, The Journal of pediatrics, 153, 535–40, 2008 [<a href="https://pubmed.ncbi.nlm.nih.gov/18589451" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18589451</span></a>]
|
|
</td><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention does not meet the inclusion criteria; study focus is on amino acid dose and starting time.</td></tr><tr><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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Blanco, Cynthia Liudmilla, Gong, Alice Kim, Green, Belinda Kay, Falck, Alison, Schoolfield, John, Liechty, Edward A., Early changes in plasma amino acid concentrations during aggressive nutritional therapy in extremely low birth weight infants, The Journal of pediatrics, 158, 543–548.e1, 2011 [<a href="https://pubmed.ncbi.nlm.nih.gov/21129755" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21129755</span></a>]
|
|
</td><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention does not meet the inclusion criteria; study focus is on amino acid dose and starting time.</td></tr><tr><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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Bulbul, Ali, Okan, Fusun, Bulbul, Lida, Nuhoglu, Asiye, Effect of low versus high early parenteral nutrition on plasma amino acid profiles in very low birth-weight infants, The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 25, 770–6, 2012 [<a href="https://pubmed.ncbi.nlm.nih.gov/21770835" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21770835</span></a>]
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|
</td><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention does not meet the inclusion criteria; both groups received early PN.</td></tr><tr><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Can, E., Bulbul, A., Uslu, S., Comert, S., Bolat, F., Nuhoglu, A., Evaluation of two different types of parenteral nutrition on early growth of preterm infants, Early Human Development, 86, S85, 2010
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|
</td><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Conference abstract.</td></tr><tr><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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|
Can, Emrah, Bulbul, Ali, Uslu, Sinan, Bolat, Fatih, Comert, Serdar, Nuhoglu, Asiye, Early Aggressive Parenteral Nutrition Induced High Insulin-like growth factor 1 (IGF-1) and insulin-like growth factor binding protein 3 (IGFBP3) Levels Can Prevent Risk of Retinopathy of Prematurity, Iranian journal of pediatrics, 23, 403–10, 2013 [<a href="/pmc/articles/PMC3883369/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3883369</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/24427493" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24427493</span></a>]
|
|
</td><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention does not meet the inclusion criteria; both groups started PN at the same time.</td></tr><tr><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Chan, S. H. T., Johnson, M. J., Vollmer, B., Early nutrition and neurodevelopmental outcomes in very preterm infants: A systematic review and meta-analysis, Developmental Medicine and Child Neurology, 56, 42–43, 2014
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|
</td><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Conference abstract.</td></tr><tr><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Dinerstein, A., Nieto, R. M., Solana, C. L., Perez, G. P., Otheguy, L. E., Larguia, A. M., Early and aggressive nutritional strategy (parenteral and enteral) decreases postnatal growth failure in very low birth weight infants, Journal of Perinatology, 26, 436–42, 2006 [<a href="https://pubmed.ncbi.nlm.nih.gov/16801958" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 16801958</span></a>]
|
|
</td><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention does not meet the inclusion criteria; the nutrition strategy includes EN.</td></tr><tr><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Donovan, Ramona, Puppala, Bhagya, Angst, Denise, Coyle, Bryan W., Outcomes of early nutrition support in extremely low-birth-weight infants, Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition, 21, 395–400, 2006 [<a href="https://pubmed.ncbi.nlm.nih.gov/16870808" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 16870808</span></a>]
|
|
</td><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not meet inclusion criteria; retrospective chart review.</td></tr><tr><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Elstgeest, Liset E., Martens, Shirley E., Lopriore, Enrico, Walther, Frans J., te Pas, Arjan B., Does parenteral nutrition influence electrolyte and fluid balance in preterm infants in the first days after birth?, PLoS ONE, 5, e9033, 2010 [<a href="/pmc/articles/PMC2815790/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC2815790</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/20140260" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20140260</span></a>]
|
|
</td><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes do not meet the inclusion criteria: Serum sodium, potassium levels and fluid balance.</td></tr><tr><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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|
Fivez, T, Kerklaan, D, Verbruggen, S, Vanhorebeek, I, Verstraete, S, Tibboel, D, Guerra, Gg, Wouters, Pj, Joffe, A, Joosten, K, Mesotten, D, Berghe, G, Impact of withholding early parenteral nutrition completing enteral nutrition in pediatric critically ill patients (PEPaNIC trial): study protocol for a randomized controlled trial, Trials, 16, 202, 2015 [<a href="/pmc/articles/PMC4422419/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4422419</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/25927936" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25927936</span></a>]
|
|
</td><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Protocol paper.</td></tr><tr><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Geary, C. A., Fonseca, R. A., Caskey, M. A., Malloy, M. H., Improved growth and decreased morbidities in <1000 g neonates after early management changes, Journal of perinatology : official journal of the California Perinatal Association, 28, 347–53, 2008 [<a href="https://pubmed.ncbi.nlm.nih.gov/18337743" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18337743</span></a>]
|
|
</td><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention does not meet the inclusion criteria; both groups received early PN at the same time.</td></tr><tr><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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|
Genoni, G., Binotti, M., Monzani, A., Bernascone, E., Stasi, I., Bona, G., Ferrero, F., Nonrandomised interventional study showed that early aggressive nutrition was effective in reducing postnatal growth restriction in preterm infants, Acta Paediatrica, International Journal of Paediatrics, 106, 1589–1595, 2017 [<a href="https://pubmed.ncbi.nlm.nih.gov/28632972" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28632972</span></a>]
|
|
</td><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention does not meet the inclusion criteria; both intervention and comparative historical cohorts started PN on day 1 of life.</td></tr><tr><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Haghedooren, R., Jenniskens, M., Guiza, F., Verbruggen, S., Guerra, G., Joosten, K., Langouche, L., Van Den Berghe, G., Prevalence and prognostic value of abnormal liver test results in critically ill children and the impact of nutrition hereon, Critical Care, 22, 2018 [<a href="/pmc/articles/PMC6282934/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6282934</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/30234740" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30234740</span></a>]
|
|
</td><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not meet protocol eligibility criteria - conference abstract.</td></tr><tr><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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|
Heimler, Ruth, Bamberger, Janine M., Sasidharan, Ponthenkandath, The effects of early parenteral amino acids on sick premature infants, Indian journal of pediatrics, 77, 1395–9, 2010 [<a href="https://pubmed.ncbi.nlm.nih.gov/20830534" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20830534</span></a>]
|
|
</td><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention does not meet the inclusion criteria; study focus is on Amino Acids.</td></tr><tr><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Ho, Man-Yau, Yen, Y. u-Hsuan, Hsieh, Mao-Chih, Chen, Hsiang-Yin, Chien, Shu-Chen, Hus-Lee, Shing-Mei, Early versus late nutrition support in premature neonates with respiratory distress syndrome, Nutrition (Burbank, Los Angeles County, Calif.), 19, 257–60, 2003 [<a href="https://pubmed.ncbi.nlm.nih.gov/12620530" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 12620530</span></a>]
|
|
</td><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention does not meet the inclusion criteria; study focus is on Amino Acids.</td></tr><tr><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Jimenez, Lissette, Mehta, Nilesh M., Duggan, Christopher P., Timing of the initiation of parenteral nutrition in critically ill children, Current Opinion in Clinical Nutrition and Metabolic Care, 20, 227–231, 2017 [<a href="/pmc/articles/PMC5844227/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5844227</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/28376054" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28376054</span></a>]
|
|
</td><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not meet protocol eligibility criteria - not a systematic review.</td></tr><tr><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Joffe, Ari, Anton, Natalie, Lequier, Laurance, Vandermeer, Ben, Tjosvold, Lisa, Larsen, Bodil, Hartling, Lisa, Nutritional support for critically ill children, Cochrane Database of Systematic Reviews, 2016 [<a href="/pmc/articles/PMC6517095/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6517095</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/27230550" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27230550</span></a>]
|
|
</td><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Participants do not meet the inclusion criteria; children aged 1 to 18 years.</td></tr><tr><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Kennedy, K. A., Tyson, J. E., Chamnanvanikij, S., Early versus delayed initiation of progressive enteral feedings for parenterally fed low birth weight or preterm infants, The Cochrane database of systematic reviews, CD001970, 2000 [<a href="https://pubmed.ncbi.nlm.nih.gov/10796276" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10796276</span></a>]
|
|
</td><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention does not fit the inclusion criteria; timing of EN feeding.</td></tr><tr><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Kotsopoulos, K., Benadiba-Torch, A., Cuddy, A., Shah, P. S., Safety and efficacy of early amino acids in preterm <28 weeks’ gestation: Prospective observational comparison, Journal of Perinatology, 26, 749–754, 2006 [<a href="https://pubmed.ncbi.nlm.nih.gov/17024139" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 17024139</span></a>]
|
|
</td><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention does not meet the inclusion criteria; study focus is on Amino Acids.</td></tr><tr><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Leenders, Erika K. S. M., de Waard, Marita, van Goudoever, Johannes B., Low- versus High-Dose and Early versus Late Parenteral Amino-Acid Administration in Very-Low-Birth-Weight Infants: A Systematic Review and Meta-Analysis, Neonatology, 113, 187–205, 2018 [<a href="https://pubmed.ncbi.nlm.nih.gov/29268262" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29268262</span></a>]
|
|
</td><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Systematic review - references cross-checked.</td></tr><tr><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Loys, C. M., Maucort-Boulch, D., Guy, B., Putet, G., Picaud, J. C., Hays, S., Extremely low birthweight infants: how neonatal intensive care unit teams can reduce postnatal malnutrition and prevent growth retardation, Acta Paediatrica, 102, 242–8, 2013 [<a href="https://pubmed.ncbi.nlm.nih.gov/23167480" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23167480</span></a>]
|
|
</td><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention does not meet the inclusion criteria; comparison includes earlier introduction of lipids and protein and EN.</td></tr><tr><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Mamunes,P., Baden,M., Bass,J.W., Nelson,J., Early intravenous feeding of the low birth weight neonate, Pediatrics, 43, 241–250, 1969 [<a href="https://pubmed.ncbi.nlm.nih.gov/4974283" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 4974283</span></a>]
|
|
</td><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Interventions does not meet the inclusion criteria; early intravenous (IV group) versus delayed oral feedings (fasted group).</td></tr><tr><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Morgan, Jessie, Young, Lauren, McGuire, William, Delayed introduction of progressive enteral feeds to prevent necrotising enterocolitis in very low birth weight infants, Cochrane Database of Systematic Reviews, 2014 [<a href="/pmc/articles/PMC7063979/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7063979</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/25436902" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25436902</span></a>]
|
|
</td><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention does not meet the inclusion criteria; timing of EN feeding.</td></tr><tr><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Moyses, H. E., Johnson, M. J., Cornelius, V., Leaf, A. A., Is there any benefit to starting total parenteral nutrition early in very low birth weight infants?
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|
A systematic review, Proceedings of the Nutrition Society, 70, E259, 2011
|
|
</td><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Conference abstract.</td></tr><tr><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Moyses, Helen E., Johnson, Mark J., Leaf, Alison A., Cornelius, Victoria R., Early parenteral nutrition and growth outcomes in preterm infants: a systematic review and meta-analysis, The American journal of clinical nutrition, 97, 816–26, 2013 [<a href="https://pubmed.ncbi.nlm.nih.gov/23446896" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23446896</span></a>]
|
|
</td><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Systematic review, references checked for inclusion. Article is in Chinese.</td></tr><tr><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Radmacher, P. G., Lewis, S. L., Adamkin, D. H., Early amino acids and the metabolic response of ELBW infants (< or = 1000 g) in three time periods, Journal of perinatology : official journal of the California Perinatal Association, 29, 433–7, 2009 [<a href="https://pubmed.ncbi.nlm.nih.gov/19339983" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19339983</span></a>]
|
|
</td><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention does not meet the inclusion criteria; the study focus is on Amino Acids.</td></tr><tr><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Rao, S., Rao, U., Jape, G., Early versus late parnteral nutrition in critically ill full term neonates: A systematic review, Journal of Paediatrics and Child Health, 53, 49, 2017
|
|
</td><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Conference abstract.</td></tr><tr><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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|
Ribed Sanchez, A., Romero Jimenez, R. M., Sanchez De Orgaz, M. C., De Juan, A., Tovar Pozo, M., Diaz Garzon, J., Sanjurjo Saez, M., Early aggressive parenteral nutrition in preterm infants, International Journal of Clinical Pharmacy, 35, 983, 2013
|
|
</td><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Conference abstract.</td></tr><tr><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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|
Stensvold, Hans Jorgen, Strommen, Kenneth, Lang, Astri M., Abrahamsen, Tore G., Steen, Eline Kjorsvik, Pripp, Are H., Ronnestad, Arild E., Early Enhanced Parenteral Nutrition, Hyperglycemia, and Death Among Extremely Low-Birth-Weight Infants, JAMA pediatrics, 169, 1003–10, 2015 [<a href="https://pubmed.ncbi.nlm.nih.gov/26348113" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26348113</span></a>]
|
|
</td><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not meet the inclusion criteria; observational cohort study.</td></tr><tr><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
te Braake, F. W. J., van den Akker, C. H. P., Riedijk, M. A., van Goudoever, J. B., Parenteral amino acid and energy administration to premature infants in early life, Seminars in Fetal and Neonatal Medicine, 12, 11–18, 2007 [<a href="https://pubmed.ncbi.nlm.nih.gov/17142119" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 17142119</span></a>]
|
|
</td><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Non-systematic review.</td></tr><tr><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Tewari, Vishal Vishnu, Dubey, Sachin Kumar, Kumar, Reema, Vardhan, Shakti, Sreedhar, C. M., Gupta, Girish, Early versus Late Enteral Feeding in Preterm Intrauterine Growth Restricted Neonates with Antenatal Doppler Abnormalities: An Open-Label Randomized Trial, Journal of tropical pediatrics, 2017 [<a href="https://pubmed.ncbi.nlm.nih.gov/28369652" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28369652</span></a>]
|
|
</td><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention does not meet the inclusion criteria; babies receive breast milk.</td></tr><tr><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Tim-Aroon, Thipwimol, Harmon, Heidi M., Nock, Mary L., Viswanathan, Sreekanth K., McCandless, Shawn E., Stopping Parenteral Nutrition for 3 Hours Reduces False Positives in Newborn Screening, The Journal of pediatrics, 167, 312–6, 2015 [<a href="https://pubmed.ncbi.nlm.nih.gov/26003996" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26003996</span></a>]
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</td><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention does not meet the inclusion criteria; study focus is on Amino Acids.</td></tr><tr><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Trintis,J., Donohue,P., Aucott,S., Outcomes of early parenteral nutrition for premature infants, Journal of Perinatology, 30, 403–407, 2010 [<a href="https://pubmed.ncbi.nlm.nih.gov/19865093" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19865093</span></a>]
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</td><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention does not meet the inclusion criteria; study focus is on Amino Acids.</td></tr><tr><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Trivedi,A., Sinn,J.K., Early versus late administration of amino acids in preterm infants receiving parenteral nutrition, Cochrane Database of Systematic Reviews, -, 2013 [<a href="https://pubmed.ncbi.nlm.nih.gov/23881744" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23881744</span></a>]
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</td><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention does not meet the inclusion criteria; study focus is on Amino Acids.</td></tr><tr><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Valentine, C. J., Fernandez, S., Rogers, L. K., Gulati, P., Hayes, J., Lore, P., Puthoff, T., Dumm, M., Jones, A., Collins, K., Curtiss, J., Hutson, K., Clark, K., Welty, S. E., Early amino-acid administration improves preterm infant weight, Journal of Perinatology, 29, 428–432, 2009 [<a href="/pmc/articles/PMC2834366/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC2834366</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/19444236" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19444236</span></a>]
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</td><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention does not meet the inclusion criteria; study focus is on Amino Acids.</td></tr><tr><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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van Puffelen, Esther, Hulst, Jessie M., Vanhorebeek, Ilse, Dulfer, Karolijn, Van den Berghe, Greet, Verbruggen, Sascha C. A. T., Joosten, Koen F. M., Outcomes of Delaying Parenteral Nutrition for 1 Week vs Initiation Within 24 Hours Among Undernourished Children in Pediatric Intensive Care: A Subanalysis of the PEPaNIC Randomized Clinical Trial, JAMA network open, 1, e182668, 2018 [<a href="/pmc/articles/PMC6324499/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6324499</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/30646158" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30646158</span></a>]
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</td><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Results not presented separately for neonates.</td></tr><tr><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Vanhorebeek, Ilse, Verbruggen, Sascha, Casaer, Michael P., Gunst, Jan, Wouters, Pieter J., Hanot, Jan, Guerra, Gonzalo Garcia, Vlasselaers, Dirk, Joosten, Koen, Van den Berghe, Greet, Effect of early supplemental parenteral nutrition in the paediatric ICU: a preplanned observational study of post-randomisation treatments in the PEPaNIC trial, The Lancet. Respiratory medicine, 5, 475–483, 2017 [<a href="https://pubmed.ncbi.nlm.nih.gov/28522351" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28522351</span></a>]
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</td><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not meet inclusion criteria; observational study (follow up study of PEPaNIC trial - PN in critically ill children).</td></tr><tr><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Verstraete, Soren, Verbruggen, Sascha C., Hordijk, Jose A., Vanhorebeek, Ilse, Dulfer, Karolijn, Guiza, Fabian, van Puffelen, Esther, Jacobs, An, Leys, Sandra, Durt, Astrid, Van Cleemput, Hanna, Eveleens, Renate D., Garcia Guerra, Gonzalo, Wouters, Pieter J., Joosten, Koen F., Van den Berghe, Greet, Long-term developmental effects of withholding parenteral nutrition for 1 week in the paediatric intensive care unit: a 2-year follow-up of the PEPaNIC international, randomised, controlled trial, The Lancet. Respiratory medicine, 7, 141–153, 2019 [<a href="https://pubmed.ncbi.nlm.nih.gov/30224325" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30224325</span></a>]
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</td><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study intervention does not meet protocol eligibility criteria - PN administered as supplement to EN.</td></tr><tr><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Weiler, Hope A., Fitzpatrick-Wong, Shirley C., Schellenberg, Jeannine M., Fair, Denise E., McCloy, Ursula R., Veitch, Rebecca R., Kovacs, Heather R., Seshia, Mary M., Minimal enteral feeding within 3 d of birth in prematurely born infants with birth weight < or = 1200 g improves bone mass by term age, The American journal of clinical nutrition, 83, 155–62, 2006 [<a href="https://pubmed.ncbi.nlm.nih.gov/16403735" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 16403735</span></a>]
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</td><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention does not meet inclusion criteria; study focus is on Amino Acids.</td></tr><tr><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Whitfield, M. F., Spitz, L., Milner, R. D., Clinical and metabolic consequences of two regimens of total parenteral nutrition in the newborn, Archives of Disease in Childhood, 58, 168–75, 1983 [<a href="/pmc/articles/PMC1627832/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC1627832</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/6404225" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 6404225</span></a>]
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</td><td headers="hd_h_niceng154er2.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Interventions do not meet inclusion criteria; study compares sequential versus continuous regimens.</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng154er2appltab1"><div id="niceng154er2.appl.tab1" class="table"><h3><span class="label">Table 8</span><span class="title">Research recommendation rationale</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK555668/table/niceng154er2.appl.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng154er2.appl.tab1_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng154er2.appl.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Research question</th><th id="hd_h_niceng154er2.appl.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For neonates where parenteral nutrition is required, what is the optimal timeframe for doing this?</th></tr></thead><tbody><tr><th headers="hd_h_niceng154er2.appl.tab1_1_1_1_1 hd_h_niceng154er2.appl.tab1_1_1_1_2" id="hd_b_niceng154er2.appl.tab1_1_1_1_1" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">Why is this needed</th></tr><tr><td headers="hd_h_niceng154er2.appl.tab1_1_1_1_1 hd_b_niceng154er2.appl.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>Importance to ‘patients’ or the population</b>
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</td><td headers="hd_h_niceng154er2.appl.tab1_1_1_1_2 hd_b_niceng154er2.appl.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">High: The timing of starting PN administration is crucial in order to avoid nutritional deficits and exposure to risks associated with PN administration.</td></tr><tr><td headers="hd_h_niceng154er2.appl.tab1_1_1_1_1 hd_b_niceng154er2.appl.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>Relevance to NICE guidance</b>
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</td><td headers="hd_h_niceng154er2.appl.tab1_1_1_1_2 hd_b_niceng154er2.appl.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">High: Only four, randomised studies were identified for inclusion in this review. The evidence that was identified was limited in quality and did not reflect current good clinical practice. Findings from the included studies were inconsistent and the studies did not provide data to determine the optimal timing of starting PN administration in clearly defined populations (particularly in term babies who are critically ill or require surgery).</td></tr><tr><td headers="hd_h_niceng154er2.appl.tab1_1_1_1_1 hd_b_niceng154er2.appl.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>Relevance to the NHS</b>
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</td><td headers="hd_h_niceng154er2.appl.tab1_1_1_1_2 hd_b_niceng154er2.appl.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">High: Identifying the timeframe for starting PN in clearly defined populations (i.e. critically ill term babies and surgical babies) is critical for the provision of optimum care and to ensure optimal growth, development and survival.</td></tr><tr><td headers="hd_h_niceng154er2.appl.tab1_1_1_1_1 hd_b_niceng154er2.appl.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>National priorities</b>
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</td><td headers="hd_h_niceng154er2.appl.tab1_1_1_1_2 hd_b_niceng154er2.appl.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The NHS <a href="https://www.longtermplan.nhs.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Long term plan</a> (launched in January 2019) for the next 10 years highlights ‘enabling everyone to get the best start in life’ as one of the main areas to improve the quality of patient care and health outcomes.</td></tr><tr><td headers="hd_h_niceng154er2.appl.tab1_1_1_1_1 hd_b_niceng154er2.appl.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>Current evidence base</b>
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</td><td headers="hd_h_niceng154er2.appl.tab1_1_1_1_2 hd_b_niceng154er2.appl.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The guideline identified that there is a gap in the evidence base. The four studies had small sample sizes (450 babies included across four studies), and were considered to be very low quality, with a high risk of bias. Furthermore, the studies were heterogeneous with regard to definitions for early PN and were not considered to provide PN formulations that would now be considered optimal.</td></tr><tr><td headers="hd_h_niceng154er2.appl.tab1_1_1_1_1 hd_b_niceng154er2.appl.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>Equality</b>
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</td><td headers="hd_h_niceng154er2.appl.tab1_1_1_1_2 hd_b_niceng154er2.appl.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Some parents and carers may need information in different languages and there may be cultural sensitivities around PN. Those with learning disabilities may need additional support.</td></tr><tr><td headers="hd_h_niceng154er2.appl.tab1_1_1_1_1 hd_b_niceng154er2.appl.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>Feasibility</b>
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</td><td headers="hd_h_niceng154er2.appl.tab1_1_1_1_2 hd_b_niceng154er2.appl.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">This would require NHS ethical approval but would be feasible and safe to conduct.</td></tr><tr><td headers="hd_h_niceng154er2.appl.tab1_1_1_1_1 hd_b_niceng154er2.appl.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>Other comments</b>
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</td><td headers="hd_h_niceng154er2.appl.tab1_1_1_1_2 hd_b_niceng154er2.appl.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">NHS: National Health Service; NICE: National Institute for Health and Care Excellence; PN: Parenteral nutrition</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng154er2appltab2"><div id="niceng154er2.appl.tab2" class="table"><h3><span class="label">Table 9</span><span class="title">Research recommendation modified PICO table</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK555668/table/niceng154er2.appl.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng154er2.appl.tab2_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng154er2.appl.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Criterion</th><th id="hd_h_niceng154er2.appl.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Explanation</th></tr></thead><tbody><tr><td headers="hd_h_niceng154er2.appl.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>Population</b>
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</td><td headers="hd_h_niceng154er2.appl.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul><li class="half_rhythm"><div>Critically ill babies born > 37 weeks of gestational age, up to 28 days after their due date (term babies) including those requiring surgery.</div></li></ul></td></tr><tr><td headers="hd_h_niceng154er2.appl.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>Intervention</b>
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</td><td headers="hd_h_niceng154er2.appl.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Early start of PN (defined as within 48 hours)</td></tr><tr><td headers="hd_h_niceng154er2.appl.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>Comparator</b>
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</td><td headers="hd_h_niceng154er2.appl.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Late start of PN (later than 2 days)</td></tr><tr><td headers="hd_h_niceng154er2.appl.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>Outcomes</b>
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</td><td headers="hd_h_niceng154er2.appl.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Survival to discharge</p>
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<p>Rates of nosocomial infections</p>
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<p>Incidence of hypoglycaemia</p>
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<p>Neurodevelopment</p>
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<p>Growth</p>
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<p>Infection</p>
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<p>Body composition</p>
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<p>Adverse effects of PN</p>
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</td></tr><tr><td headers="hd_h_niceng154er2.appl.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>Study design</b>
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</td><td headers="hd_h_niceng154er2.appl.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Randomised controlled trial</td></tr><tr><td headers="hd_h_niceng154er2.appl.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>Timeframe</b>
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</td><td headers="hd_h_niceng154er2.appl.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">From birth to discharge</td></tr><tr><td headers="hd_h_niceng154er2.appl.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>Additional information</b>
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</td><td headers="hd_h_niceng154er2.appl.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The decision was made not to specifically defined the timeframe of ‘early’ or ‘late’ in the protocol because it was recognised that this could be interpreted as the ‘time from birth to starting PN’ or as ‘the time from birth to the decision to start PN’, which could take into account an initial trial of enteral feeding. This could lead to very different timings and would mean what definitions of ‘early’ in one study may be ‘late’ in another. The timing would therefore be extracted directly as reported in the studies and the details of this taken into consideration in the discussion.</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">PN: Parenteral nutrition</p></div></dd></dl></dl></div></div></div></article></div><div id="jr-scripts"><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/libs.min.js"> </script><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.min.js"> </script></div></div>
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