The Role of Nutrition Support in Pediatric Patients with Solid Malignancies: A Systematic Review

Bibliographic Details
Main Author:	Welin, Elizabeth
Language:	English
Published:	University of Cincinnati / OhioLINK 2013
Subjects:	Nutrition pediatric oncology nutrition
Online Access:	http://rave.ohiolink.edu/etdc/view?acc_num=ucin1367934883

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spelling	ndltd-OhioLink-oai-etd.ohiolink.edu-ucin13679348832021-08-03T05:23:05Z The Role of Nutrition Support in Pediatric Patients with Solid Malignancies: A Systematic Review Welin, Elizabeth Nutrition pediatric oncology nutrition Objective. Using the evidence-analysis process of the Academy of Nutrition and Dietetics, we systematically examined the evidence between nutrition interventions (enteral and parenteral feeding) and four outcome variables (nutrition status, treatment delays, protein-energy malnutrition, and rate of infection) in pediatric patients with solid, malignant tumors. Methods. Four evidence-analysis questions were formulated based on nutritional care and practice for pediatric-oncology patients. An electronic literature search of three databases, EBSCOhost, GoogleScholar, and PubMed was carried out. Studies were classified by study design and then assigned a quality rating using standardized criteria research which included items such as potential sources of bias, the research question, variables, study groups, blinding, methods, outcomes, and the validity and reliability of the results. A conclusion statement was then assigned for each evidence-analysis question based on the results of the review. An evidence grade of I (strong), II (fair), III (weak), IV (expert opinion only), or V (no evidence) was assigned to each statement indicating the strength of the evidence. Results. Two non-randomized control trials, two non-randomized control/cohort studies, and one cohort study were evaluated to determine the impact of enteral and/or parenteral nutrition support on nutrition status of pediatric oncology patients with solid malignancies. One non-randomized control trial found that 40% of patients (N = 46) receiving gastrostomy tube feedings reached >95% of their desirable body weight after a mean of 4.9 months. One non-randomized control/cohort study (N = 24) found that patients receiving total parenteral nutrition (TPN) increased their weight by 17 ± 2%, and patients receiving peripheral parenteral nutrition plus enteral nutrition (PPN + EN) increased their weight by 11 ± 2% (p < 0.05). One non-randomized control/cohort study found that TPN for 9-14 days did not improve nutritional status, but TPN for 28 days did. One non-randomized control trial found that patients receiving TPN or PPN had a median weight change of +2.67% (95% CI, range -1.22% - +9.20%, p = 0.03) 1 month after initiation of cancer therapy and +5.23% (95% CI, range -4.88% - +14.61%, p >0.05), 3 months after initiation of cancer therapy. Two non-randomized control trials and three randomized control trials evaluated the impact of enteral and parenteral nutrition support on treatment delays in pediatric oncology patients with solid malignancies. One non-randomized trial found that 15% of patients receiving TPN had treatment delays. One randomized control trial found that patients receiving TPN had significant improvements in weight and triceps skinfold thicknesses and experienced less treatment delays than those not receiving TPN (p < 0.001). Conclusions. The evidence for enteral and/or parenteral nutrition support improving nutrition status was strong (grade I). The evidence of parenteral and/or enteral nutrition support in preventing treatment delays and reversing protein-energy malnutrition was fair (grade II). The evidence for enteral and/or parenteral nutrition support in decreasing infection rate was weak (grade III) and more research is needed. 2013-10-11 English text University of Cincinnati / OhioLINK http://rave.ohiolink.edu/etdc/view?acc_num=ucin1367934883 http://rave.ohiolink.edu/etdc/view?acc_num=ucin1367934883 unrestricted This thesis or dissertation is protected by copyright: all rights reserved. It may not be copied or redistributed beyond the terms of applicable copyright laws.
collection	NDLTD
language	English
sources	NDLTD
topic	Nutrition pediatric oncology nutrition
spellingShingle	Nutrition pediatric oncology nutrition Welin, Elizabeth The Role of Nutrition Support in Pediatric Patients with Solid Malignancies: A Systematic Review
author	Welin, Elizabeth
author_facet	Welin, Elizabeth
author_sort	Welin, Elizabeth
title	The Role of Nutrition Support in Pediatric Patients with Solid Malignancies: A Systematic Review
title_short	The Role of Nutrition Support in Pediatric Patients with Solid Malignancies: A Systematic Review
title_full	The Role of Nutrition Support in Pediatric Patients with Solid Malignancies: A Systematic Review
title_fullStr	The Role of Nutrition Support in Pediatric Patients with Solid Malignancies: A Systematic Review
title_full_unstemmed	The Role of Nutrition Support in Pediatric Patients with Solid Malignancies: A Systematic Review
title_sort	role of nutrition support in pediatric patients with solid malignancies: a systematic review
publisher	University of Cincinnati / OhioLINK
publishDate	2013
url	http://rave.ohiolink.edu/etdc/view?acc_num=ucin1367934883
work_keys_str_mv	AT welinelizabeth theroleofnutritionsupportinpediatricpatientswithsolidmalignanciesasystematicreview AT welinelizabeth roleofnutritionsupportinpediatricpatientswithsolidmalignanciesasystematicreview
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The Role of Nutrition Support in Pediatric Patients with Solid Malignancies: A Systematic Review

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