Paediatric anaesthesia & critical care
Increased ureagenesis revealing metabolic intolerance to enhanced nutrition in the PICU: a secondary analysis of the PEPaNIC RCT
Authors' conclusion
Increased plasma/serum urea or UCR with early-PN partially explained the harm by early-PN, suggesting these may identify critically ill children metabolically intolerant to enhanced nutrition.
Study context
- Population
- Critically ill children (newborn-17 years) in pediatric intensive care units (PICUs) (Leuven-Rotterdam-Edmonton), not receiving renal replacement therapy (RRT)PEPaNIC-patients recruited
- Participants
- 1,440 children
- Comparison
- Association of first-week maximum UCR with outcomes; early-PN vs late-PN
- early-PNn = 665
- late-PNn = 663reference
- Primary endpoint
- Risk of new infections and duration of PICU dependency
Methodological detailsmulticentre
- Multicentre
Primary result
As reported in the abstract
Higher first week maximum UCR (per 30 age-normalized units)
Higher first week maximum UCREstimate (95% CI)P value
New infection
adjusted OR 1.746(1.353–2.265)
P < 0.0001Earlier live PICU discharge
adjusted HR 0.745(0.671–0.824)
P < 0.0001Per 30 age-normalized units, as printed
Secondary outcomes
| Outcome | Estimate | P value | |
|---|---|---|---|
| Earlier live hospital discharge, per 30 age-normalized units of first week maximum UCR | adjusted HR 0.778 (CI 0.703–0.860) | P < 0.0001 | |
| 90-day mortality, per 30 age-normalized units of first week maximum UCR | adjusted OR 1.432 (CI 1.029–1.993) | P = 0.033 | |
| 0.512Ratio (log scale) |
Urea and UCR, early-PN vs late-PN · first 11 days
- Urea concentrations and UCRs higher in early-PN than late-PN
Urea concentrations
- Similar results obtained for urea concentrations
Original publication
Increased ureagenesis revealing metabolic intolerance to enhanced nutrition in the PICU: a secondary analysis of the PEPaNIC RCT. Crit Care. Published 25 September 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →