Nutritional support in the critical ill patient: Requirements, prescription and adherence

array:24 ["pii" => "S2341287923001643" "issn" => "23412879" "doi" => "10.1016/j.anpede.2023.07.005" "estado" => "S300" "fechaPublicacion" => "2023-08-01" "aid" => "3462" "copyright" => "Asociación Española de Pediatría" "copyrightAnyo" => "2023" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "An Pediatr (Barc). 2023;99:94-101" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S1695403323001236" "issn" => "16954033" "doi" => "10.1016/j.anpedi.2023.05.010" "estado" => "S300" "fechaPublicacion" => "2023-08-01" "aid" => "3462" "copyright" => "Asociación Española de Pediatría" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "An Pediatr (Barc). 2023;99:94-101" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "es" => array:14 [ "idiomaDefecto" => true "cabecera" => "Original" "titulo" => "Soporte nutricional en el paciente crítico: requerimiento, prescripción y cumplimiento" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:3 [ 0 => "es" 1 => "es" 2 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "94" "paginaFinal" => "101" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Nutritional support in the critical ill patient: Requirements, prescription and adherence" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 1 "multimedia" => array:5 [ "identificador" => "fig0015" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => false "mostrarDisplay" => true "figura" => array:1 [ 0 => array:4 [ "imagen" => "fx1.jpeg" "Alto" => 750 "Ancho" => 1333 "Tamanyo" => 157225 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Camila Vergara, Paulina del Pozo, Jessie Niklitschek, Catalina Le Roy" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Camila" "apellidos" => "Vergara" ] 1 => array:2 [ "nombre" => "Paulina" "apellidos" => "del Pozo" ] 2 => array:2 [ "nombre" => "Jessie" "apellidos" => "Niklitschek" ] 3 => array:2 [ "nombre" => "Catalina" "apellidos" => "Le Roy" ] ] ] ] "resumen" => array:1 [ 0 => array:3 [ "titulo" => "Graphical abstract" "clase" => "graphical" "resumen" => "<elsevierMultimedia ident="fig0015"></elsevierMultimedia>" ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2341287923001643" "doi" => "10.1016/j.anpede.2023.07.005" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287923001643?idApp=UINPBA00005H" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403323001236?idApp=UINPBA00005H" "url" => "/16954033/0000009900000002/v2_202403140519/S1695403323001236/v2_202403140519/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S234128792300159X" "issn" => "23412879" "doi" => "10.1016/j.anpede.2023.07.003" "estado" => "S300" "fechaPublicacion" => "2023-08-01" "aid" => "3463" "copyright" => "Asociación Española de Pediatría" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "An Pediatr (Barc). 2023;99:102-10" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "Original Article" "titulo" => "Prevalence of gastrointestinal symptoms in autism spectrum disorder: A meta-analysis" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:3 [ 0 => "en" 1 => "en" 2 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "102" "paginaFinal" => "110" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Prevalencia de síntomas gastrointestinales en trastornos del espectro del autismo: un metaanálisis" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 1 "multimedia" => array:5 [ "identificador" => "fig0035" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => false "mostrarDisplay" => true "figura" => array:1 [ 0 => array:4 [ "imagen" => "fx1.jpeg" "Alto" => 753 "Ancho" => 1333 "Tamanyo" => 118863 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Isabel Lasheras, Matias Real-López, Javier Santabárbara" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Isabel" "apellidos" => "Lasheras" ] 1 => array:2 [ "nombre" => "Matias" "apellidos" => "Real-López" ] 2 => array:2 [ "nombre" => "Javier" "apellidos" => "Santabárbara" ] ] ] ] "resumen" => array:1 [ 0 => array:3 [ "titulo" => "Graphical abstract" "clase" => "graphical" "resumen" => "<elsevierMultimedia ident="fig0035"></elsevierMultimedia>" ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1695403323001248" "doi" => "10.1016/j.anpedi.2023.05.011" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403323001248?idApp=UINPBA00005H" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S234128792300159X?idApp=UINPBA00005H" "url" => "/23412879/0000009900000002/v2_202403140552/S234128792300159X/v2_202403140552/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2341287923001527" "issn" => "23412879" "doi" => "10.1016/j.anpede.2023.04.012" "estado" => "S300" "fechaPublicacion" => "2023-08-01" "aid" => "3454" "copyright" => "Asociación Española de Pediatría" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "An Pediatr (Barc). 2023;99:82-93" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "Original Article" "titulo" => "Spanish adaptation and validation of the empowerment of parents in the intensive care-neonatology (EMPATHIC-N) questionnaire" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:3 [ 0 => "en" 1 => "en" 2 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "82" "paginaFinal" => "93" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Adaptación y validación española del Empowerment of Parents in the Intensive Care-Neonatology (EMPATHIC-N)" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 1 "multimedia" => array:5 [ "identificador" => "fig0005" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => false "mostrarDisplay" => true "figura" => array:1 [ 0 => array:4 [ "imagen" => "fx1.jpeg" "Alto" => 775 "Ancho" => 1333 "Tamanyo" => 158581 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Cristina Ruiz-González, Patricia Martín-Casas, Jos M. Latour, Ana Úbeda-Tikkanen, Ibai López-de-Uralde-Villanueva, Susana Sánchez-Aparicio García, Natalia Cuadrado-Obregón" "autores" => array:7 [ 0 => array:2 [ "nombre" => "Cristina" "apellidos" => "Ruiz-González" ] 1 => array:2 [ "nombre" => "Patricia" "apellidos" => "Martín-Casas" ] 2 => array:2 [ "nombre" => "Jos M." "apellidos" => "Latour" ] 3 => array:2 [ "nombre" => "Ana" "apellidos" => "Úbeda-Tikkanen" ] 4 => array:2 [ "nombre" => "Ibai" "apellidos" => "López-de-Uralde-Villanueva" ] 5 => array:2 [ "nombre" => "Susana" "apellidos" => "Sánchez-Aparicio García" ] 6 => array:2 [ "nombre" => "Natalia" "apellidos" => "Cuadrado-Obregón" ] ] ] ] "resumen" => array:1 [ 0 => array:3 [ "titulo" => "Graphical abstract" "clase" => "graphical" "resumen" => "<elsevierMultimedia ident="fig0005"></elsevierMultimedia>" ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1695403323001157" "doi" => "10.1016/j.anpedi.2023.04.010" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403323001157?idApp=UINPBA00005H" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287923001527?idApp=UINPBA00005H" "url" => "/23412879/0000009900000002/v2_202403140552/S2341287923001527/v2_202403140552/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "Original Article" "titulo" => "Nutritional support in the critical ill patient: Requirements, prescription and adherence" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "94" "paginaFinal" => "101" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Camila Vergara, Paulina del Pozo, Jessie Niklitschek, Catalina Le Roy" "autores" => array:4 [ 0 => array:3 [ "nombre" => "Camila" "apellidos" => "Vergara" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "Paulina" "apellidos" => "del Pozo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Jessie" "apellidos" => "Niklitschek" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 3 => array:4 [ "nombre" => "Catalina" "apellidos" => "Le Roy" "email" => array:1 [ 0 => "catalinaleroy@yahoo.es" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] 2 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Departamento de Gastroenterología y Nutrición Pediátrica, División de Pediatría, Escuela de Medicina Pontificia Universidad Católica de Chile, Santiago, Chile" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Unidad Académica de Cuidados Intensivos Pediátricos, Departamento de Pediatría, División de Pediatría, Escuela de Medicina Pontificia Universidad Católica de Chile, Santiago, Chile" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Departamento de Pediatría y Cirugía Infantil, Campus Centro, Facultad de Medicina, Universidad de Chile, Santiago, Chile" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Soporte nutricional en el paciente crítico: requerimiento, prescripción y cumplimiento" ] ] "resumenGrafico" => array:2 [ "original" => 1 "multimedia" => array:5 [ "identificador" => "fig0015" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => false "mostrarDisplay" => true "figura" => array:1 [ 0 => array:4 [ "imagen" => "fx1.jpeg" "Alto" => 750 "Ancho" => 1333 "Tamanyo" => 153542 ] ] ] ] "textoCompleto" => "IntroductionThe nutritional support of critically ill patients continues to be a challenge for the care team. It is difficult to estimate the requirements of these patients, select the route of delivery and assess adherence due to the characteristics of medically complex patients, who experience shifting disease dynamics and metabolic stress that further complicate the delivery of nutritional support.<a class="elsevierStyleCrossRef" href="#bib0005">1</a> Critical illness is conceived as having three phases.<a class="elsevierStyleCrossRef" href="#bib0010">2</a> The acute phase may last from hours to days, during which the main goal of treatment is to maintain the functions of vital organs, and is characterised, among other features, by an increase in inflammation, the involvement of counterregulatory hormones, protein and fatty acid catabolism and peripheral inactivation of thyroid hormones and insulin-like growth factor 1 (IGF1). It is followed by the stable phase, characterised by stabilization or weaning of vital organ support, which lasts from a few days to weeks. Last of all, there is the recovery phase, during which metabolic, endocrine and immunological disturbances normalise and protein anabolism increases.<a class="elsevierStyleCrossRef" href="#bib0015">3</a> Depending on the phase of illness, there are changes in energy<a class="elsevierStyleCrossRef" href="#bib0020">4</a> and protein requirements and enteral tolerance,<a class="elsevierStyleCrossRefs" href="#bib0025">5,6</a> haemodynamics and fluid and electrolyte balance in addition to metabolic and endocrine changes.<a class="elsevierStyleCrossRef" href="#bib0035">7</a>International guidelines agree that energy requirements during the acute phase of illness should be calculated by means of indirect calorimetry or, if not available, the factorial method (Schofield equation).<a class="elsevierStyleCrossRefs" href="#bib0040">8,9</a> One meta-analysis estimated that the Schofield equation, whether using only the weight or both the weight and the height, could predict the basal metabolic rate (BMR) with an error of ±15%.<a class="elsevierStyleCrossRefs" href="#bib0050">10,11</a> When it comes to protein, current guidelines recommend guaranteeing an intake of at least 1.5 g of protein per day during the acute phase.<a class="elsevierStyleCrossRefs" href="#bib0040">8,12,13</a>Delivering adequate nutritional support in this clinical context is challenging, and malnutrition is a frequent problem in critically ill paediatric patients. On one hand, providing an excessive amount of nutrients may lead to overfeeding, which carries a risk of cellular damage and metabolic disturbances,<a class="elsevierStyleCrossRef" href="#bib0070">14</a> while an insufficient intake is associated with increases in morbidity, mortality and length of stay.<a class="elsevierStyleCrossRefs" href="#bib0020">4,15,16</a> Insufficient nutrient delivery is usually due to either prescribing of insufficient doses or poor adherence.<a class="elsevierStyleCrossRefs" href="#bib0085">17,18</a> There are many reasons that may contribute to inadequate adherence to prescribed nutrition, which may be related to the phase of illness; changes in gastrointestinal motility are more frequent during the acute phase, as are haemodynamic, metabolic and endocrine changes. This determines the number of required procedures, the need of fluid restriction etc.,<a class="elsevierStyleCrossRef" href="#bib0095">19</a> which, in plain terms, are associated with an increase in the number of interruptions and decrease in adherence to prescribed nutrition.<a class="elsevierStyleCrossRef" href="#bib0085">17</a> There is substantial variability between previous studies in the reported nutrients delivered in relation to the nutrients prescribed, ranging from 25% to 59% of the prescribed energy intake and 32.7%–93.6% of the prescribed protein intake,<a class="elsevierStyleCrossRefs" href="#bib0020">4,11,20–22</a> depending on the population under study, the expertise of the care time, the estimated time elapsed to achievement of nutritional goals, the availability of systems to monitor nutrition, the use of protocols and the severity of disease.<a class="elsevierStyleCrossRefs" href="#bib0005">1,16,23,24</a>The aim of our study was to assess the association between prescribing, requirements and adherence with nutritional support, specifically the energy and protein intake, based on the phase of disease in critically ill paediatric patients.Sample and methodsWe conducted a prospective observational descriptive and analytical study.We included patients aged 0–18 years admitted for a minimum of 24 h to the paediatric intensive and intermediate care unit of the Hospital Clínico of the Pontificia Universidad Católica between August 2020 and January 2021. We excluded patients predominantly fed by the oral route, defined as receiving more than 70% of prescribed nutrition through this route, and patients admitted for an elective procedure for multidisciplinary assessment in the absence of acute illness.For the total study period, we selected 3 days per month at random using Excel. The principal investigator collected the data for the past 24 h by reviewing the medical and nursing records for the patients. This amounted to a total of 18 days of data, which were then anonymised and coded for subsequent analysis.The study was exploratory and the patients were selected by convenience sampling.We collected data on the following variables: sex, age (in complete months), weight (kg) and height (cm) at admission, diagnosis at admission (respiratory, cardiovascular, neurologic, infectious, trauma/orthopaedics, haematological/oncological, postsurgical, other), comorbidity (yes/no; defined as the presence of any disease concomitant to the primary diagnosis at admission) and type of comorbidity (respiratory, cardiovascular, neurologic, infectious, trauma/orthopaedics, haematological/oncological, postsurgical, other). The nutritional status of the patient was assessed using the 2006 World Health Organization (WHO) child growth standards for children aged 0–5 years<a class="elsevierStyleCrossRef" href="#bib0125">25</a> and the 2007 WHO growth reference data for children aged 5–18 years<a class="elsevierStyleCrossRef" href="#bib0130">26</a> as reference, in adherence with current domestic guidelines.<a class="elsevierStyleCrossRef" href="#bib0135">27</a> In the case of patients with Down syndrome, we used the weight (Wt)-for-age and height (Ht)-for-age growth charts published by Zemel et al.,<a class="elsevierStyleCrossRef" href="#bib0140">28</a> in addition to the WHO weight-for-height and body mass index (BMI)-for-age charts for children aged more than 5 years to diagnose excess weight. For patients with cerebral palsy, we used the growth charts of Brooks et al.<a class="elsevierStyleCrossRef" href="#bib0145">29</a> adjusted according to the Gross Motor Function Classification System (GMFCS) for the Wt-for-age and Ht-for-age. Based on the Wt-for-age distribution, we defined undernutrition as a weight below the 10th percentile (P10), risk of undernutrition as a weight between the P10 and the 25th percentile (P25), adequate nutrition as a weight between the P25 and the 75th percentile (P75), overweight as a weight between the P75 and the 95th percentile (P95) and obesity as a weight above the P95.We defined short stature as a height at or below the P10 in the Zemel and Brooks growth charts.The basal metabolic rate was calculated with the Schofield equation using the weight or the weight and height. We obtained the prescribed amounts of energy and protein from the prescription issued by the treating physician and the actual amount of delivered nutrition (adherence) from the nursing records, expressed as kcal/kg/day and grams of protein/kg/day. We recorded the total nutrient intake, regardless of the route of delivery.We calculated the following ratios: prescribed nutrition/BMR (P/BMR), delivered nutrition (adherence)/BMR (A/BMR), delivered nutrition (adherence)/prescribed nutrition (A/P). We classified the energy intake as underfeeding (<90%), adequate nutrition (90%–110%) or overfeeding (>110%).<a class="elsevierStyleCrossRef" href="#bib0115">23</a> For protein, we classified intake as inadequate (<1.5 g protein/kg/day) or adequate (≥1.5 g protein/kg/day).<a class="elsevierStyleCrossRefs" href="#bib0040">8,12,13</a>We recorded the route of administration (oral, enteral, parenteral), the enteral feeding method (bolus, continuous feeding), any suspensions of nutritional support and the reason for the suspension (procedure involving airway management, gastrointestinal dysfunction, diagnostic procedure, mechanical problem).We classified the phase of illness as acute or non-acute based on a checklist designed by the research team that took into account different physiological variables and classification criteria by disease by system, defining acute illness as meeting one or more of the criteria in the list (Appendix A, Supplemental material 1).Ethical considerationsThe study adhered to the principles of the Declaration of Helsinki. The study was approved by the Health Sciences Scientific and Ethics Committee of the School of Medicine of Pontificia Universidad Católica de Chile (no. 200122005) and considered exempt from the need of informed consent, given its observational nature and that contact with patients or families was not required to collect the necessary data.Statistical analysisThe statistical analyses were carried out with the following software packages: STATA version 13, prism version 9.0, SPSS version 28.0.1.0. We summarised categorical variables as absolute and relative frequencies. We used the Shapiro–Wilk test to analyse the distribution of continuous variables, which were summarised as median and interquartile range (IQR). To compare the prescription, delivery (adherence) and BMR ratios in the acute and non-acute phases of disease, we carried out an inferential analysis using the χ2 test or Fisher exact test, as applicable, and the Wilcoxon test. We calculated the Spearman correlation coefficient for the P/BMR ratios for energy intake and protein intake. We considered P values of less than 0.05 statistically significant.ResultsThe sample included 131 patients (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> presents their demographic characteristics and nutritional data). The nutritional status could be determined in 116 patients, and a full nutritional evaluation was possible in 94 patients for whom weight and height data were available. Out of the total sample, 9 patients had GMFCS level V cerebral palsy and 12 had Down syndrome. Of note, 32.8% had undernutrition and 36.6% had adequate nutrition. The predominant feeding modality was exclusive enteral nutrition (77.1%), and the most frequent reason for suspension of nutritional support was performance of an invasive procedure.<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>The BMR was calculated with the weight Schofield equation in 39 patients (29.77%) and the weight-height Schofield equation in 92 (70.23%).Among the patients managed with enteral feeding, nutrition was delivered through a gastrostomy tube in 24 (21.1%), through a nasogastric tube in 76 (66.7%), and through a nasojejunal tube in 14 (12.3%). The enteral feeding modality was bolus feeding in 67 patients (58.8%) and continuous feeding in 47 patients (41.2%).<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> presents the ratios of energy and protein intake requirements, amounts prescribed and amounts delivered (adherence) in the total sample and by phase of illness. We found a correlation coefficient of 0.6 for the association between the energy P/BMR and the protein prescription/protein requirements (R) (P/R), and no correlation between the protein requirement/delivery (adherence) and the A/P.<elsevierMultimedia ident="tbl0010"></elsevierMultimedia> presents the distribution of underfeeding, adequate nutrition and overfeeding based on the energy intake for each of the ratios under study (P/BMR, A/BMR and A/P), and we found a statistically significant difference (P < 0.00001) on account of overfeeding for all ratios. <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> presents the distribution by phase of disease (acute vs. non-acute).<elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a> presents the distribution of prescribed and delivered protein in the total sample and by phase of illness, and the most salient findings were the prescription of more than 1.5 g of protein/kg/day in 56.5% of the sample and the adherence to the prescription in 51.9%. We found significant differences between the prescribed amount and the delivered amount (adherence) in the groups with prescriptions of more or less than 1.5 g de protein/kg/day by phase of disease (Fisher test P = 0.016 and P = 0.007, respectively).<elsevierMultimedia ident="tbl0020"></elsevierMultimedia><a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a> compares the energy P/BMR, A/P and A/BMR by phase of illness, showing that the ratios were higher in non-acute patients.<elsevierMultimedia ident="fig0010"></elsevierMultimedia>The analysis of the variables associated with adherence to the prescribed energy intake revealed a higher frequency of underfeeding compared to the prescribed amount in patients at risk of undernutrition (7/10) (P = 0.001). On the other hand, eutrophic patients and patients with excess malnutrition have adherence of the prescription of 90-110% (adequate) with greater frequency (45/73) (p = 0.001).Most patients in the acute phase of illness (9/13) were underfed compared to the prescribed nutrition (<90%). In contrast, in the non-acute group, adherence was adequate (90%–110%) in most patients (78/118). A small number (3/118) even received more than was prescribed (>110%) (P = 0.007). We did not find statistically significant differences in the frequency distribution of acute vs. non-acute patients by reason for suspension of nutritional therapy (P = 0.074) or type of nutritional support (P = 0.237).DiscussionSeveral reports indicate that the protein and energy requirements of patients admitted to intensive care units are frequently not met (A/R and A/BMR) during the acute phase of illness.<a class="elsevierStyleCrossRefs" href="#bib0090">18,19,22,24</a>In our study, we found that three fifths of patients had an energy intake meeting their BMR and half had a protein intake meeting their protein requirements (A/R), with a higher proportion of patients with intakes meeting the BMR in the non-acute versus the acute phase of illness, in agreement with previous studies that found that delivery of the full required amount was harder in the early days of the intensive care unit stay, which usually correspond to the acute phase.<a class="elsevierStyleCrossRefs" href="#bib0115">23,30,31</a>A noteworthy finding in our study was that the percentage of patients in the acute phase of illness was low for the paediatric critical care setting.In the assessment of the prescribed energy intake, based on the widespread consensus for the optimal nutrition of paediatric patients, with calculation of the BMR by means of the Schofield equation,<a class="elsevierStyleCrossRefs" href="#bib0040">8,12</a> we found that only a small percentage of patients had an adequate energy intake prescription (P/BMR), with an insufficient or excessive prescription in most patients, more frequently the latter.Given that the acute phase of illness is characterised by ongoing changes in metabolism, the Schofield formula used in isolation cannot account for changes in metabolism following injury and can overestimate energy requirements, as observed by Mehta et al.<a class="elsevierStyleCrossRef" href="#bib0160">32</a> in a study in which they compared indirect calorimetry measurements with these equations, highlighting the overestimation of energy requirements using equations due to hypometabolism in these patients. Other studies, like the one conducted by Oosterveld et al.,<a class="elsevierStyleCrossRef" href="#bib0165">33</a> have not found significant differences between the calculation of the resting energy expenditure rate using indirect calorimetry and the Schofield equation, which reinforces what we have noted above, that energy requirements in these patients can be underestimated as well as overestimated.In the assessment by phase of illness, we found that the median prescribed energy intake in patients in the acute phase was approximately half the BMR (P/BMR), similar to the findings of studies like the one published by De Jonghe et al.,<a class="elsevierStyleCrossRef" href="#bib0085">17</a> who reported prescriptions of 78% of the energy requirements in these patients, or the study by McClave et al.,<a class="elsevierStyleCrossRef" href="#bib0170">34</a> who reported prescription of 65.6% of the estimated requirements.It is well known that critical illness is associated with protein catabolism, which has a negative impact in terms of an increase in both morbidity and mortality and a more difficult recovery.<a class="elsevierStyleCrossRefs" href="#bib0065">13,35</a> When we analysed the prescribed protein intake in relation to the protein requirements (P/R) and the adherence to this prescription, we found that in most patients the prescribed and actual intakes adhered to current recommendations,<a class="elsevierStyleCrossRefs" href="#bib0040">8,12,13</a> with greater adherence compared to other studies; thus, Kyle et al.<a class="elsevierStyleCrossRef" href="#bib0105">21</a> reported a protein intake of 40.4% of the protein requirements and Wong et al.<a class="elsevierStyleCrossRef" href="#bib0180">36</a> an intake of only 13.1% of estimated requirements on day 3 of the intensive care unit stay. We must underscore the importance of delivering nutrition consistent with current recommendations to avoid malnutrition and a negative protein balance.<a class="elsevierStyleCrossRef" href="#bib0185">37</a> In the group of patients with acute illness, we found that 23% had prescriptions for less than 1.5 g of protein per kg of body weight, which was consistent with the studies cited above.When we assessed adherence with the prescribed energy intake (A/P), we found that one third of the patients were underfed, a proportion that was lower than reported by De Jonghe et al.,<a class="elsevierStyleCrossRef" href="#bib0085">17</a> who found that 90.1% of the amount prescribed was delivered, and Li et al.,<a class="elsevierStyleCrossRef" href="#bib0110">22</a> who found a percentage of underfeeding of 85%.It is worth noting that patients in the acute metabolic stress phase only achieved two thirds of the prescribed intake for both energy and protein. When we explored the variables that may have played a role in this outcome, we found that most patients who did not achieve a delivered/prescribed ratio greater than 90% had experienced interruptions to nutritional support, and invasive, non-invasive procedures and airway management procedures accounted for more than half of the interruptions. In addition, we found that suspensions of nutritional support were more frequent in patients at risk of undernutrition, although we were able to determine the cause or find an association with any of the variables under study that could explain it. This is an important finding, as these patients would be more likely to eventually become undernourished.Our findings evince the substantial proportion of critically ill paediatric patients whose intake does not meet their nutritional requirements for either energy or protein. The values observed in our study were greater compared to other studies in the literature, which in our opinion highlights the importance of implementing standardised nutritional support protocols for critical patients and a multidisciplinary approach to their management with the aim of improving these outcomes, which could be subject to study in the future.<a class="elsevierStyleCrossRef" href="#bib0120">24</a>There are limitations to our study, chief of which is that it was conducted in the context of the coronavirus disease 2019 pandemic, which changed the epidemiology of acute illness in the paediatric population and, as a result, the reasons for admission to the paediatric intensive care unit. Another limitation was the low proportion of patients in the acute phase of illness, which was defined based on the fulfilment of criteria in a checklist developed by the research team, since no existing instruments for the purpose were found, and which precluded comparisons to determine whether this low frequency would be expected in this type of paediatric unit. We did not collect data on the length of stay in the hospital and in the paediatric intensive care or intermediate care units or the duration of nutritional support to provide a more detailed interpretation of the results. Last of all, we did not compare the estimated energy requirements with values obtained by indirect calorimetry (the gold standard) or estimated protein requirements with the nitrogen balance to carry out the analyses, which would have allowed a more accurate assessment of individual requirements. One of the strengths of the study is that we integrated the phase of illness in the analysis in relation to the estimated BMR, the prescribed nutrition and the amounts that could actually be delivered, a novel approach that provides a more thorough understanding of the timing, amount and route of delivery of nutritional support in children in the intensive care unit based on the deficiencies or excesses in the nutrition that is actually delivered.ConclusionIn the sample of patients managed in the paediatric intensive and intermediate care unit, we found that the prescribed intake in relation to the BMR was appropriate in a high proportion of patients in the non-acute phase of disease, doubling the proportion with adequate prescription of energy intake and more than tripling the proportion with adequate prescription of protein intake in the group of patients in the acute phase of illness. Intake was lower in patients in the acute phase of illness.In relation to this, our findings illustrated the difficulty in achieving delivery of the total prescribed intake, and one of the main reasons for it was the frequent interruption of nutritional support, chiefly in relation to the performance of invasive procedures.On the other hand, overfeeding was frequent, more so in the non-acute phase of disease.Our findings illustrate the challenge of providing balanced nutritional support to critically ill paediatric patients, which requires ongoing evaluation through objective clinical parameters to assess the impact of prescribed nutrition in relation to the BMR.FundingThis research did not receive any external funding.Conflicts of interestThe authors have no conflicts of interest to declare." "textoCompletoSecciones" => array:1 [ "secciones" => array:13 [ 0 => array:3 [ "identificador" => "xres2107130" "titulo" => "Graphical abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0005" ] ] ] 1 => array:3 [ "identificador" => "xres2107131" "titulo" => "Abstract" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0010" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0015" "titulo" => "Objective" ] 2 => array:2 [ "identificador" => "abst0020" "titulo" => "Sample and methods" ] 3 => array:2 [ "identificador" => "abst0025" "titulo" => "Results" ] 4 => array:2 [ "identificador" => "abst0030" "titulo" => "Conclusions" ] ] ] 2 => array:2 [ "identificador" => "xpalclavsec1795305" "titulo" => "Keywords" ] 3 => array:3 [ "identificador" => "xres2107129" "titulo" => "Resumen" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0035" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0040" "titulo" => "Objetivo" ] 2 => array:2 [ "identificador" => "abst0045" "titulo" => "Pacientes y método" ] 3 => array:2 [ "identificador" => "abst0050" "titulo" => "Resultados" ] 4 => array:2 [ "identificador" => "abst0055" "titulo" => "Conclusiones" ] ] ] 4 => array:2 [ "identificador" => "xpalclavsec1795304" "titulo" => "Palabras clave" ] 5 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 6 => array:3 [ "identificador" => "sec0010" "titulo" => "Sample and methods" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Ethical considerations" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Statistical analysis" ] ] ] 7 => array:2 [ "identificador" => "sec0025" "titulo" => "Results" ] 8 => array:2 [ "identificador" => "sec0030" "titulo" => "Discussion" ] 9 => array:2 [ "identificador" => "sec0035" "titulo" => "Conclusion" ] 10 => array:2 [ "identificador" => "sec0040" "titulo" => "Funding" ] 11 => array:2 [ "identificador" => "sec0045" "titulo" => "Conflicts of interest" ] 12 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2022-09-27" "fechaAceptado" => "2023-05-22" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1795305" "palabras" => array:6 [ 0 => "Critical care" 1 => "Nutritional requirements" 2 => "Stress response" 3 => "Nutritional support" 4 => "Critical illness" 5 => "Overfeeding" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1795304" "palabras" => array:6 [ 0 => "Cuidados críticos" 1 => "Requerimiento nutricional" 2 => "Respuesta al estrés" 3 => "Soporte nutricional" 4 => "Enfermedad crítica" 5 => "Sobrealimentación pediátrica" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "IntroductionIn critically ill patients, nutritional support is a challenge in terms of both estimating their requirements and ensuring adherence to the prescribed treatment. ObjectiveTo assess the association between requirements, prescription and adherence to energy and protein supplementation based on the phase of disease in critically ill patients. Sample and methodsWe conducted a prospective, observational and analytical study in patients aged 0–18 years admitted to the paediatric intensive or intermediate care unit in 2020–2021. We collected data on demographic and anthropometric characteristics and the phase of disease (acute phase [AP] vs. non-acute phase [nAP]), in addition to prescribing (P) (indication of nutritional support), basal metabolic rate (BMR, Schofield equation), adherence to nutritional support (A) and protein requirements (R), and calculated the following ratios: P/BMR, P/R, A/BMR, A/R, and A/P. ResultsThe sample included 131 participants with a median age of 16 (4.5) months, of who 128 (97.7%) had comorbidities and 13 (9.9%) were in the AP. Comparing the phases of disease (AP vs. nAP), the median values for energy supplementation were P/BMR, 0.5 (IQR, 0.1–1.4) vs. 1.3 (IQR, 0.9–1.8) (P = 0.0054); A/BMR, 0.4 (IQR, 0–0.6) vs. 1.2 (IQR, 0.8–1.7) (P = 0.0005); A/P, 0.7 (IQR, 0–0.9) vs. 1 (IQR, 0.8–1) (P = 0.002), and for protein were P/R, 0.7 (IQR, 0–1.1) vs. 1.2 (0.9–1.6) (P = 0.0009); A/R 0.3 (IQR, 0–0.6) vs. 1.1 (IQR, 0.8–1.5) (P = 0.0002); A/P 0.7 (IQR, 0–1) vs. 1(IQR, 0.8–1) (P = 0.002). We found AP/nAP ratios greater than 110% for energy in the P/BMR (4 patients [30.8%]/72 patients [61%]; P = 0.007), A/BMR (3 [23%]/63 [53.4%]; P = 0.009) and A/P (1 [7%]/3 [2.5%]; P = 0.007). As for protein, more than 1.5 g/kg/day was prescribed in 3 patients (23.1%) in the AP and 71 (60.1%) in the nAP. We found adherence to the prescribed intake in 2 (15.4%) patients in the AP and 66 (56%) in the nAP. We found a correlation coefficient of 0.6 between the energy P/R and the protein P/R. Prescribed support was discontinued in 7 patients (53.8%) in the AP and 31 (26.3%) in the nAP (P = 0.002). ConclusionsThe proportion of adherence to prescribed nutritional support was high in patients in the nAP of the disease. Overfeeding was frequent, more so in the nAP. We identified difficulties in adhering to prescribed support, chief of which was the discontinuation of feeding." "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0010" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0015" "titulo" => "Objective" ] 2 => array:2 [ "identificador" => "abst0020" "titulo" => "Sample and methods" ] 3 => array:2 [ "identificador" => "abst0025" "titulo" => "Results" ] 4 => array:2 [ "identificador" => "abst0030" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "IntroducciónEl soporte nutricional en el paciente crítico es un desafío tanto en la estimación de requerimientos como en el cumplimiento de su prescripción. ObjetivoEvaluar las relaciones entre la prescripción, el requerimiento y el cumplimiento del soporte nutricional de energía y proteínas según la fase de la enfermedad en el paciente crítico. Pacientes y métodoEstudio observacional, analítico, de datos obtenidos a través de reclutamiento prospectivo (2020–2021), pacientes de 0–18 años hospitalizados en la unidad de cuidados intensivos o intermedios pediátrica. Se obtuvieron datos demográficos, antropométricos y del estado agudo (FA)/no agudo (FNA) de la enfermedad. Se determinaron la prescripción (P) (indicación nutricional), el gasto energético basal (GEB) (fórmula de Schofield), el cumplimiento (C) de soporte nutricional, el requerimiento (R) proteico, creándose las siguientes relaciones: P/GEB, P/R, C/GEB, C/R, C/P. ResultadosSe incluyeron 131 sujetos con una mediana de 16 (4,5) meses; el 97,7% presentaban alguna comorbilidad y el 9,9% cursaban en FA. Al comparar FA/FNA tuvieron mediana (RIC) de energía: P/GEB 0,5 (0,1–1,4)/1,3 (0,9–1,8) (p = 0,0054); C/GEB 0,4 (0–0,6)/1,2 (0,8–1,7) (p = 0,0005); C/P 0,7 (0–0,9)/1 (0,8–1) (p = 0,002). Y proteínas: P/R 0,7 (0–1,1)/1,2 (0,9–1,6) (p = 0,0009); C/R 0,3 (0–0,6)/1,1 (0,8–1,5) (p = 0,0002); C/P 0,7 (0–1)/1 (0,8–1) (p = 0,002). Se encontró para energía FA/FNA > 110% en P/GEB en 4 pacientes (30,8%)/72 (61%) (p = 0,007), C/GEB en 3 pacientes (23%)/63 (53,4%) (p = 0,009) y C/P en 1 (7%)/3 (2,5%) (p = 0,007). En proteínas se prescribió > 1,5 g/kg/día en 3 (23,1%) pacientes en FA y 71 (60,1%) en FNA. El cumplimiento de este aporte fue de 2 (15,4%) pacientes en FA y 66 (56%) en FNA. Se encontró un coeficiente de correlación de 0,6 entre P/GEB de energía con P/R proteico. La suspensión fue de 7 (53,8%) pacientes en FA y 31 (26,3%) en FNA (p = 0,002). ConclusionesLa relación de cumplimiento de la prescripción fue alta en pacientes en FNA de la enfermedad. La sobrealimentación fue frecuente, siendo mayor en FNA. Se observó dificultad para cumplir la prescripción, siendo la causa principal la suspensión de la alimentación." "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0035" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0040" "titulo" => "Objetivo" ] 2 => array:2 [ "identificador" => "abst0045" "titulo" => "Pacientes y método" ] 3 => array:2 [ "identificador" => "abst0050" "titulo" => "Resultados" ] 4 => array:2 [ "identificador" => "abst0055" "titulo" => "Conclusiones" ] ] ] ] "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:4 [ "apendice" => "The following is Supplementary data to this article:<elsevierMultimedia ident="upi0005"></elsevierMultimedia>" "etiqueta" => "Appendix A" "titulo" => "Supplementary data" "identificador" => "sec0055" ] ] ] ] "multimedia" => array:8 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 992 "Ancho" => 1675 "Tamanyo" => 58392 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0020" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Appropriateness of nutritional support based on the relationships between basal metabolic rate, prescribed nutrition and delivered nutrition (adherence). A/BMR: adherence/basal metabolic rate; A/P, adherence/prescribed; P/BMR, prescribed/basal metabolic rate." ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 901 "Ancho" => 1675 "Tamanyo" => 42822 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0025" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Prescribed intake/basal metabolic rate, adherence/prescribed intake and adherence/basal metabolic rate ratios by phase of illness. A/BMR, adherence/basal metabolic rate; A/P, adherence/prescribed intake; P/BMR, prescribed intake/basal metabolic rate. *Wilcoxon test." ] ] 2 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0030" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "IQR, interquartile range." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variable</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Male sex, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">79 (60.3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age (months), median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 (4–47) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age, n (%)</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0–12 months \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">58 (44.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12–24 months \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">19 (14.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2–5 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">34 (26) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5–10 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (1.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10–18 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18 (13.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Reason for admission, n (%)</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Infectious \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">53 (40.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Postsurgical \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">31 (23.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cardiovascular \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">19 (14.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Neurologic \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 (7.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Respiratory \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 (5.3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Other \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (6.1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Blood or solid tumour \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (2.3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Comorbidity, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">128 (97.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Type of comorbidity \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cardiovascular \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">49 (38.3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Other \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">42 (32.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Blood or solid tumour \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20 (15.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Neurologic \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 (12.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Respiratory \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (0.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Phase of illness, n (%)</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Acute \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 (9.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Non-acute \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">118 (90.1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Nutritional status,<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a>n (%)</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Undernutrition \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">32 (24.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Risk of undernutrition \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 (8.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Adequate nutrition \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">48 (36.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Overweight \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 (12.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Obesity \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 (6.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Height, n (%)<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Short statute \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">35 (37.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Feeding modality, n (%)</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Exclusive enteral nutrition \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">101 (77.1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Enteral + parenteral nutrition \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (6.1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Parenteral nutrition \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (4.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Nil per os \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (4.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Parenteral + oral nutrition \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (3.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Enteral + oral nutrition \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (3.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Suspension of nutritional support, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">38 (29.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Reason for suspension, n (%)</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Invasive procedure \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 (34.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Other \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (21) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Non-invasive diagnostic procedure \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (15.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Airway management \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (15.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Gastrointestinal dysfunction \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (10.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Mechanical problems in enteral delivery \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (2.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab3485483.png" ] ] ] "notaPie" => array:2 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "116/131." ] 1 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "b" "nota" => "94/131." ] ] ] "descripcion" => array:1 [ "en" => "Clinical, demographic and nutritional characteristics of the patients." ] ] 3 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0035" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "BMR, basal metabolic rate; IQR, interquartile range." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Total sample \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Acute phase \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Non-acute phase \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">P<a class="elsevierStyleCrossRef" href="#tblfn0015">a</a> \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 (9.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">118 (90.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Protein</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Prescribed/required, median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.09 (0.82–1.55) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.66 (0.04–1.09) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.15 (0.89–1.57) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.0009 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Delivered/required, median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.01 (0.67–1.43) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.3 (0.0–0.58) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.06 (0.79–1.48) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.0002 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Delivered/prescribed, median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (0.8−2.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.67 (0−0.96) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (0.83−1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.002 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Energy</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Prescribed/BMR, median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.27 (0.80–1.81) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.47 (0.13–1.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.3 (0.87–1.84) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.0054 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Delivered/BMR, median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.11 (0.69–1.71) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.43 (0–0.55) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.17 (0.8–1.73) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.0005 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Delivered/prescribed, median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (0.79–1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.66 (0–0.93) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (0.83–1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.002 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab3485484.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0015" "etiqueta" => "a" "nota" => "Comparison of acute phase vs. non-acute phase." ] ] ] "descripcion" => array:1 [ "en" => "Ratios of energy and protein intake requirements, prescription and delivery (adherence) in the total sample and by phase of illness." ] ] 4 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0040" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "BMR, basal metabolic rate." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td-with-role" title="\n \t\t\t\t\ttable-head\n \t\t\t\t ; entry_with_role_colgroup " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Acute (n = 13)</th><th class="td-with-role" title="\n \t\t\t\t\ttable-head\n \t\t\t\t ; entry_with_role_colgroup " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Non-acute (n = 118)</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">P \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><90% \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">90%–110% \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">>110% \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><90% \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">90%–110% \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">>110% \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Prescribed/BMR, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 (69.2%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 (0%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (30.8%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">31 (26.3%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15 (12.7%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">72 (61%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.007 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Adherence/BMR, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 (77%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 (0%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (23%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">39 (33%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 (13.6%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">63 (53.4%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.009 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Adherence/prescribed, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 (69%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (23%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (7%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">36 (30.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">79 (67%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (2.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.007 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab3485481.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Energy requirements, prescribed intake and adherence (delivered amount) to prescribed intake ratios by phase of illness." ] ] 5 => array:8 [ "identificador" => "tbl0020" "etiqueta" => "Table 4" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0045" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "IQR, interquartile range." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Variable \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Total \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td-with-role" title="\n \t\t\t\t\ttable-head\n \t\t\t\t ; entry_with_role_colgroup " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Phase of illness</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">P<a class="elsevierStyleCrossRef" href="#tblfn0020">a</a> \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Acute \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Non-acute \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Prescribed protein (g/kg/day), median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.64 (1.21–2.23) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.45 (0.1–1.42) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.71 (1.33–2.36) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.0009 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><1.5 g/kg/day</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">57 (43.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 (17.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">47 (82.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.2 (0.5−1.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.24 (0−0.51) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.2 (0.74−1.38) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.002 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">≥1.5 g/kg/day</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">74 (56.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (4.1%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">71 (95.9%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.2 (1.8–2.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.34 (1.63–3.04) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.2 (1.79–2.82) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.9891 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Delivered protein (g/kg/day), median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.51 (1–2.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.34 (0–0.43) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.6 (1.2–2.21) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.0002 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><1.5 g/kg/day</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">63 (48.1%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 (17.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">52 (82.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (0.3–1.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.16 (0–0.39) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.19 (0.49–1.35) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.0001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">≥1.5 g/kg/day</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">68 (51.9%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (2.9%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">66 (97.1%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.9 (1.7–2.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.34 (1.32-2.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.92 (1.67–2.78) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.9891 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab3485482.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0020" "etiqueta" => "a" "nota" => "Comparison of patients in acute and non-acute phases of illness." ] ] ] "descripcion" => array:1 [ "en" => "Protein intake by phase of illness." ] ] 6 => array:5 [ "identificador" => "upi0005" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:2 [ "fichero" => "mmc1.pdf" "ficheroTamanyo" => 191497 ] ] 7 => array:5 [ "identificador" => "fig0015" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => false "mostrarDisplay" => true "figura" => array:1 [ 0 => array:4 [ "imagen" => "fx1.jpeg" "Alto" => 750 "Ancho" => 1333 "Tamanyo" => 153542 ] ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:37 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Causes and consequences of inadequate substrate supply to pediatric ICU patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J.M. Hulst" 1 => "K.F. Joosten" 2 => "D. Tibboel" 3 => "J.B. van Goudoever" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/01.mco.0000222115.91783.71" "Revista" => array:6 [ "tituloSerie" => "Curr Opin Clin Nutr Metab Care" "fecha" => "2006" "volumen" => "9" "paginaInicial" => "297" "paginaFinal" => "303" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16607132" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nutritional support and the role of the stress response in critically ill children" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "K.F. Joosten" 1 => "D. Kerklaan" 2 => "S.C. Verbruggen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/MCO.0000000000000268" "Revista" => array:6 [ "tituloSerie" => "Curr Opin Clin Nutr Metab Care" "fecha" => "2016" "volumen" => "19" "paginaInicial" => "226" "paginaFinal" => "233" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26963579" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nutritional support of the critically ill pediatric patient: foundations and controversies" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "I.J. Ardila Gómez" 1 => "C.B. González" 2 => "P.A. Martínez Palacio" 3 => "E.T. Mercado Santis" 4 => "J.D. Tibaduiza Bayona" 5 => "J.P. Contreras Hernández" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1177/1179560317701108" "Revista" => array:5 [ "tituloSerie" => "Clin Med Insights: Trauma Intensive Med" "fecha" => "2017" "volumen" => "8" "paginaInicial" => "1" "paginaFinal" => "7" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Can energy intake alter clinical and hospital outcomes in PICU?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "B.M.K. Larsen" 1 => "M.R. Beggs" 2 => "A.Y. Leong" 3 => "S.H. Kang" 4 => "R. Persad" 5 => "G. Garcia Guerra" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.clnesp.2018.02.002" "Revista" => array:6 [ "tituloSerie" => "Clin Nutr ESPEN" "fecha" => "2018" "volumen" => "24" "paginaInicial" => "41" "paginaFinal" => "46" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29576361" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Definitions, predictors and outcomes of feeding intolerance in critically ill children: a systematic review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "R.D. Eveleens" 1 => "K.F.M. Joosten" 2 => "B.A.E. de Koning" 3 => "J.M. Hulst" 4 => "S.C.A.T. Verbruggen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.clnu.2019.03.026" "Revista" => array:6 [ "tituloSerie" => "Clin Nutr" "fecha" => "2020" "volumen" => "39" "paginaInicial" => "685" "paginaFinal" => "693" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30962102" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Metabolic support in the critically ill: a consensus of 19" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Wernerman" 1 => "K.B. Christopher" 2 => "D. Annane" 3 => "M.P. Casaer" 4 => "C.M. Coopersmith" 5 => "A.M. Deane" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/s13054-019-2597-0" "Revista" => array:4 [ "tituloSerie" => "Crit Care" "fecha" => "2019" "volumen" => "23" "paginaInicial" => "318" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Basics in clinical nutrition: metabolic response to injury and sepsis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "L. Sobotka" 1 => "P.B. Soeters" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.eclnm.2008.07.005" "Revista" => array:5 [ "tituloSerie" => "e-ESPEN" "fecha" => "2009" "volumen" => "4" "paginaInicial" => "e1" "paginaFinal" => "e3" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nutritional support for children during critical illness: European Society of Pediatric and Neonatal Intensive Care (ESPNIC) metabolism, endocrine and nutrition section position statement and clinical recommendations" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L.N. Tume" 1 => "F.V. Valla" 2 => "K. Joosten" 3 => "C. Jotterand Chaparro" 4 => "L. Latten" 5 => "L.V. Marino" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00134-019-05922-5" "Revista" => array:6 [ "tituloSerie" => "Intensive Care Med" "fecha" => "2020" "volumen" => "46" "paginaInicial" => "411" "paginaFinal" => "425" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32077997" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Estimation of resting energy expenditure using predictive equations in critically ill children: results of a systematic review" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C. Jotterand Chaparro" 1 => "C. Moullet" 2 => "P. Taffé" 3 => "J. Laure Depeyre" 4 => "M.H. Perez" 5 => "D. Longchamp" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/jpen.1146" "Revista" => array:6 [ "tituloSerie" => "JPEN J Parenter Enteral Nutr" "fecha" => "2018" "volumen" => "42" "paginaInicial" => "976" "paginaFinal" => "986" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29603276" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Performance of predictive equations specifically developed to estimate resting energy expenditure in ventilated critically ill children" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C. Jotterand Chaparro" 1 => "P. Taffé" 2 => "C. Moullet" 3 => "J. Laure Depeyre" 4 => "D. Longchamp" 5 => "M.H. Perez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jpeds.2016.12.063" "Revista" => array:3 [ "tituloSerie" => "J Pediatr" "fecha" => "2017" "volumen" => "184" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0055" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Predicting basal metabolic rate, new standards and review of previous work" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "W.N. Schofield" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Hum Nutr Clin Nutr" "fecha" => "1985" "volumen" => "39" "numero" => "Suppl 1" "paginaInicial" => "5" "paginaFinal" => "41" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4044297" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0060" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Guidelines for the provision and assessment of nutrition support therapy in the pediatric critically ill patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "N.M. Mehta" 1 => "H.E. Skillman" 2 => "S.Y. Irving" 3 => "J.A. Coss-Bu" 4 => "S. Vermilyea" 5 => "E.A. Farrington" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1177/0148607117711387" "Revista" => array:6 [ "tituloSerie" => "JPEN J Parenter Enteral Nutr" "fecha" => "2017" "volumen" => "41" "paginaInicial" => "706" "paginaFinal" => "742" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28686844" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0065" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Adequate enteral protein intake is inversely associated with 60-d mortality in critically ill children: a multicenter, prospective, cohort study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "N.M. Mehta" 1 => "L.J. Bechard" 2 => "D. Zurakowski" 3 => "C.P. Duggan" 4 => "D.K. Heyland" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3945/ajcn.114.104893" "Revista" => array:6 [ "tituloSerie" => "Am J Clin Nutr" "fecha" => "2015" "volumen" => "102" "paginaInicial" => "199" "paginaFinal" => "206" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25971721" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0070" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The metabolic response to stress and infection in critically ill children: the opportunity of an individualized approach" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "V. De Cosmi" 1 => "G.P. Milani" 2 => "A. Mazzocchi" 3 => "V. d’Oria" 4 => "M. Silano" 5 => "E. Calderini" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3390/nu9091032" "Revista" => array:5 [ "tituloSerie" => "Nutrients" "fecha" => "2017" "volumen" => "9" "paginaInicial" => "1032" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28926994" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0075" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Why patients in critical care do not receive adequate enteral nutrition? A review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "H. Kim" 1 => "N.A. Stotts" 2 => "E.S. Froelicher" 3 => "M.M. Engler" 4 => "C. Porter" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jcrc.2012.07.019" "Revista" => array:6 [ "tituloSerie" => "J Crit Care" "fecha" => "2012" "volumen" => "27" "paginaInicial" => "702" "paginaFinal" => "713" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23084129" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0080" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nutritional practices and their relationship to clinical outcomes in critically ill children—an international multicenter cohort study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "N.M. Mehta" 1 => "L.J. Bechard" 2 => "N. Cahill" 3 => "M. Wang" 4 => "A. Day" 5 => "C.P. Duggan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/CCM.0b013e31824e18a8" "Revista" => array:6 [ "tituloSerie" => "Crit Care Med" "fecha" => "2012" "volumen" => "40" "paginaInicial" => "2204" "paginaFinal" => "2211" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22564954" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0085" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A prospective survey of nutritional support practices in intensive care unit patients: what is prescribed? What is delivered?" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "B. De Jonghe" 1 => "C. Appere-De-Vechi" 2 => "M. Fournier" 3 => "B. Tran" 4 => "J. Merrer" 5 => "J.C. Melchior" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/00003246-200101000-00002" "Revista" => array:6 [ "tituloSerie" => "Crit Care Med" "fecha" => "2001" "volumen" => "29" "paginaInicial" => "8" "paginaFinal" => "12" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11176150" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0090" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Challenges to optimal enteral nutrition in a multidisciplinary pediatric intensive care unit" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "N.M. Mehta" 1 => "D. McAleer" 2 => "S. Hamilton" 3 => "E. Naples" 4 => "K. Leavitt" 5 => "P. Mitchell" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1177/0148607109348065" "Revista" => array:5 [ "tituloSerie" => "JPEN J Parenter Enteral Nutr" "fecha" => "2010" "volumen" => "34" "paginaInicial" => "38" "paginaFinal" => "45" ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0095" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "What are the factors that influence the attainment of satisfactory energy intake in pediatric intensive care unit patients receiving enteral or parenteral nutrition?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "F.S. De Menezes" 1 => "H.P. Leite" 2 => "P.C. Nogueira" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.nut.2012.04.003" "Revista" => array:6 [ "tituloSerie" => "Nutrition" "fecha" => "2013" "volumen" => "29" "paginaInicial" => "76" "paginaFinal" => "80" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22898265" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0100" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Barriers to adequate nutrition in critically ill children" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "E.J. Rogers" 1 => "H.R. Gilbertson" 2 => "R.G. Heine" 3 => "R. Henning" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/s0899-9007(03)00170-9" "Revista" => array:6 [ "tituloSerie" => "Nutrition" "fecha" => "2003" "volumen" => "19" "paginaInicial" => "865" "paginaFinal" => "868" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14559322" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0105" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nutrition support in critically ill children: underdelivery of energy and protein compared with current recommendations" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "U.G. Kyle" 1 => "N. Jaimon" 2 => "J.A. Coss-Bu" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jand.2012.07.038" "Revista" => array:6 [ "tituloSerie" => "J Acad Nutr Diet" "fecha" => "2012" "volumen" => "112" "paginaInicial" => "1987" "paginaFinal" => "1992" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23063414" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0110" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nutritional survey in critically ill children: a single center study in China" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Li" 1 => "B. Li" 2 => "J. Qian" 3 => "J. Zhang" 4 => "H. Ren" 5 => "B. Ning" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.21037/tp-19-173" "Revista" => array:6 [ "tituloSerie" => "Transl Pediatr" "fecha" => "2020" "volumen" => "9" "paginaInicial" => "221" "paginaFinal" => "230" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32775240" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0115" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nutritional goals, prescription and delivery in a pediatric intensive care unit" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. De Neef" 1 => "V.G. Geukers" 2 => "A. Dral" 3 => "R. Lindeboom" 4 => "H.P. Sauerwein" 5 => "A.P. Bos" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.clnu.2007.10.013" "Revista" => array:6 [ "tituloSerie" => "Clin Nutr" "fecha" => "2008" "volumen" => "27" "paginaInicial" => "65" "paginaFinal" => "71" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18068875" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0120" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Implementation of nutrition support guidelines may affect energy and protein intake in the pediatric intensive care unit" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "U.G. Kyle" 1 => "L.A. Lucas" 2 => "G. Mackey" 3 => "J.C. Silva" 4 => "J. Lusk" 5 => "R. Orellana" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jand.2016.01.005" "Revista" => array:6 [ "tituloSerie" => "J Acad Nutr Diet" "fecha" => "2016" "volumen" => "116" "paginaInicial" => "844" "paginaFinal" => "851" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27126156" "web" => "Medline" ] ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0125" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Patrones de crecimiento de lactantes, niños y niñas menores de 5 años (OMS 2006) [Accessed 22 April 2022]. Available from: <a target="_blank" href="http://www.who.int/childgrowth/standards/es/">http://www.who.int/childgrowth/standards/es/</a>." ] ] ] 25 => array:3 [ "identificador" => "bib0130" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Patrones de crecimiento de escolares y adolescentes entre 5 años 1 mes y 19 años (OMS 2007) [Accessed 22 April 2022]. Available from: <a target="_blank" href="http://www.who.int/growthref/en/">http://www.who.int/growthref/en/</a>." ] ] ] 26 => array:3 [ "identificador" => "bib0135" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Patrones de crecimiento para la evaluación nutricional de niños, niñas y adolescentes desde el nacimiento hasta los 19 años de edad,Ministerio de Salud, 2018 [Accessed 22 April 2022]. Available from: <a target="_blank" href="http://www.bibliotecaminsal.cl/wp/wp-content/uploads/2018/07/2018.06.14-PAC_Interior-con-lineas-de-corte-14-juliov3.pdf">http://www.bibliotecaminsal.cl/wp/wp-content/uploads/2018/07/2018.06.14-PAC_Interior-con-lineas-de-corte-14-juliov3.pdf</a>." ] ] ] 27 => array:3 [ "identificador" => "bib0140" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Growth charts for children with down syndrome in the United States" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "B.S. Zemel" 1 => "M. Pipan" 2 => "V.A. Stallings" 3 => "W. Hall" 4 => "K. Schadt" 5 => "D.S. Freedman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1542/peds.2015-1652" "Revista" => array:6 [ "tituloSerie" => "Pediatrics" "fecha" => "2015" "volumen" => "136" "paginaInicial" => "e1204" "paginaFinal" => "e1211" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26504127" "web" => "Medline" ] ] ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib0145" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Low weight, morbidity, and mortality in children with cerebral palsy: new clinical growth charts" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J. Brooks" 1 => "S. Day" 2 => "R. Shavelle" 3 => "D. Strauss" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1542/peds.2010-2801" "Revista" => array:6 [ "tituloSerie" => "Pediatrics" "fecha" => "2011" "volumen" => "128" "paginaInicial" => "e299" "paginaFinal" => "e307" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21768315" "web" => "Medline" ] ] ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib0150" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Barriers to adequate nutrition in critically ill children" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "E.J. Rogers" 1 => "H.R. Gilbertson" 2 => "R.G. Heine" 3 => "R. Henning" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/s0899-9007(03)00170-9" "Revista" => array:6 [ "tituloSerie" => "Nutrition" "fecha" => "2003" "volumen" => "19" "paginaInicial" => "865" "paginaFinal" => "868" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14559322" "web" => "Medline" ] ] ] ] ] ] ] ] 30 => array:3 [ "identificador" => "bib0155" "etiqueta" => "31" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The effect of cumulative energy and protein deficiency on anthropometric parameters in a pediatric ICU population" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.M. Hulst" 1 => "J.B. van Goudoever" 2 => "L.J. Zimmermann" 3 => "W.C. Hop" 4 => "M.J. Albers" 5 => "D. Tibboel" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.clnu.2004.05.006" "Revista" => array:6 [ "tituloSerie" => "Clin Nutr" "fecha" => "2004" "volumen" => "23" "paginaInicial" => "1381" "paginaFinal" => "1389" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15556260" "web" => "Medline" ] ] ] ] ] ] ] ] 31 => array:3 [ "identificador" => "bib0160" "etiqueta" => "32" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Energy imbalance and the risk of overfeeding in critically ill children" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "N.M. Mehta" 1 => "L.J. Bechard" 2 => "M. Dolan" 3 => "K. Ariagno" 4 => "H. Jiang" 5 => "C. Duggan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/PCC.0b013e3181fe279c" "Revista" => array:6 [ "tituloSerie" => "Pediatr Crit Care Med" "fecha" => "2011" "volumen" => "12" "paginaInicial" => "398" "paginaFinal" => "405" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20975614" "web" => "Medline" ] ] ] ] ] ] ] ] 32 => array:3 [ "identificador" => "bib0165" "etiqueta" => "33" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Energy expenditure and balance following pediatric intensive care unit admission: a longitudinal study of critically ill children" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M.J. Oosterveld" 1 => "M. van der Kuip" 2 => "K. de Meer" 3 => "H.J. de Greef" 4 => "R.J. Gemke" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/01.PCC.0000194011.18898.90" "Revista" => array:6 [ "tituloSerie" => "Pediatr Crit Care Med" "fecha" => "2006" "volumen" => "7" "paginaInicial" => "147" "paginaFinal" => "153" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16531947" "web" => "Medline" ] ] ] ] ] ] ] ] 33 => array:3 [ "identificador" => "bib0170" "etiqueta" => "34" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Enteral tube feeding in the intensive care unit: factors impeding adequate delivery" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S.A. McClave" 1 => "L.K. Sexton" 2 => "D.A. Spain" 3 => "J.L. Adams" 4 => "N.A. Owens" 5 => "M.B. Sullins" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/00003246-199907000-00003" "Revista" => array:6 [ "tituloSerie" => "Crit Care Med" "fecha" => "1999" "volumen" => "27" "paginaInicial" => "1252" "paginaFinal" => "1256" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10446815" "web" => "Medline" ] ] ] ] ] ] ] ] 34 => array:3 [ "identificador" => "bib0175" "etiqueta" => "35" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "American Society for Parenteral and Enteral Nutrition Board of Directors, Clinical guidelines for the use of parenteral and enteral nutrition in adult and pediatric patients: applying the GRADE system to development of A.S.P.E.N. clinical guidelines" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.E. Druyan" 1 => "C. Compher" 2 => "J.I. Boullata" 3 => "C.L. Braunschweig" 4 => "D.E. George" 5 => "E. Simpser" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1177/0148607111420157" "Revista" => array:6 [ "tituloSerie" => "JPEN J Parenter Enteral Nutr" "fecha" => "2012" "volumen" => "36" "paginaInicial" => "77" "paginaFinal" => "80" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22179521" "web" => "Medline" ] ] ] ] ] ] ] ] 35 => array:3 [ "identificador" => "bib0180" "etiqueta" => "36" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nutrition delivery affects outcomes in pediatric acute respiratory distress syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J.J. Wong" 1 => "W.M. Han" 2 => "R. Sultana" 3 => "T.F. Loh" 4 => "J.H. Lee" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1177/0148607116637937" "Revista" => array:6 [ "tituloSerie" => "JPEN J Parenter Enteral Nutr" "fecha" => "2017" "volumen" => "41" "paginaInicial" => "1007" "paginaFinal" => "1113" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26962064" "web" => "Medline" ] ] ] ] ] ] ] ] 36 => array:3 [ "identificador" => "bib0185" "etiqueta" => "37" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "How much protein and energy are needed to equilibrate nitrogen and energy balances in ventilated critically ill children?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "C. Jotterand Chaparro" 1 => "J. Laure Depeyre" 2 => "D. Longchamp" 3 => "M.H. Perez" 4 => "P. Taffé" 5 => "J. Cotting" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.clnu.2015.03.015" "Revista" => array:6 [ "tituloSerie" => "Clin Nutr" "fecha" => "2016" "volumen" => "35" "paginaInicial" => "460" "paginaFinal" => "467" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25912187" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23412879/0000009900000002/v2_202403140552/S2341287923001643/v2_202403140552/en/main.assets" "Apartado" => array:4 [ "identificador" => "26005" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original Articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23412879/0000009900000002/v2_202403140552/S2341287923001643/v2_202403140552/en/main.pdf?idApp=UINPBA00005H&text.app=https://analesdepediatria.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287923001643?idApp=UINPBA00005H"]

Statistics

Original Article

Nutritional support in the critical ill patient: Requirements, prescription and adherence

Soporte nutricional en el paciente crítico: requerimiento, prescripción y cumplimiento

Camila Vergaraa, Paulina del Pozob, Jessie Niklitscheka, Catalina Le Roya,c,

Corresponding author

catalinaleroy@yahoo.es

Corresponding author.

a Departamento de Gastroenterología y Nutrición Pediátrica, División de Pediatría, Escuela de Medicina Pontificia Universidad Católica de Chile, Santiago, Chile

b Unidad Académica de Cuidados Intensivos Pediátricos, Departamento de Pediatría, División de Pediatría, Escuela de Medicina Pontificia Universidad Católica de Chile, Santiago, Chile

c Departamento de Pediatría y Cirugía Infantil, Campus Centro, Facultad de Medicina, Universidad de Chile, Santiago, Chile

Read

2623

Times
was read the article

662

Total PDF

1961

Total HTML

Share statistics

 array:24 [
  "pii" => "S2341287923001643"
  "issn" => "23412879"
  "doi" => "10.1016/j.anpede.2023.07.005"
  "estado" => "S300"
  "fechaPublicacion" => "2023-08-01"
  "aid" => "3462"
  "copyright" => "Asociaci&#243;n Espa&#241;ola de Pediatr&#237;a"
  "copyrightAnyo" => "2023"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "fla"
  "cita" => "An Pediatr &#40;Barc&#41;. 2023;99:94-101"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:1 [
    "total" => 0
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S1695403323001236"
      "issn" => "16954033"
      "doi" => "10.1016/j.anpedi.2023.05.010"
      "estado" => "S300"
      "fechaPublicacion" => "2023-08-01"
      "aid" => "3462"
      "copyright" => "Asociaci&#243;n Espa&#241;ola de Pediatr&#237;a"
      "documento" => "article"
      "crossmark" => 1
      "subdocumento" => "fla"
      "cita" => "An Pediatr &#40;Barc&#41;. 2023;99:94-101"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:1 [
        "total" => 0
      ]
      "es" => array:14 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Original</span>"
        "titulo" => "Soporte nutricional en el paciente cr&#237;tico&#58; requerimiento&#44; prescripci&#243;n y cumplimiento"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "tieneResumen" => array:3 [
          0 => "es"
          1 => "es"
          2 => "en"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "94"
            "paginaFinal" => "101"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Nutritional support in the critical ill patient&#58; Requirements&#44; prescription and adherence"
          ]
        ]
        "contieneResumen" => array:2 [
          "es" => true
          "en" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 1
          "multimedia" => array:5 [
            "identificador" => "fig0015"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => false
            "mostrarDisplay" => true
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "fx1.jpeg"
                "Alto" => 750
                "Ancho" => 1333
                "Tamanyo" => 157225
              ]
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Camila Vergara, Paulina del Pozo, Jessie Niklitschek, Catalina Le Roy"
            "autores" => array:4 [
              0 => array:2 [
                "nombre" => "Camila"
                "apellidos" => "Vergara"
              ]
              1 => array:2 [
                "nombre" => "Paulina"
                "apellidos" => "del Pozo"
              ]
              2 => array:2 [
                "nombre" => "Jessie"
                "apellidos" => "Niklitschek"
              ]
              3 => array:2 [
                "nombre" => "Catalina"
                "apellidos" => "Le Roy"
              ]
            ]
          ]
        ]
        "resumen" => array:1 [
          0 => array:3 [
            "titulo" => "Graphical abstract"
            "clase" => "graphical"
            "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall"><elsevierMultimedia ident="fig0015"></elsevierMultimedia></p></span>"
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2341287923001643"
          "doi" => "10.1016/j.anpede.2023.07.005"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287923001643?idApp=UINPBA00005H"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403323001236?idApp=UINPBA00005H"
      "url" => "/16954033/0000009900000002/v2_202403140519/S1695403323001236/v2_202403140519/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S234128792300159X"
    "issn" => "23412879"
    "doi" => "10.1016/j.anpede.2023.07.003"
    "estado" => "S300"
    "fechaPublicacion" => "2023-08-01"
    "aid" => "3463"
    "copyright" => "Asociaci&#243;n Espa&#241;ola de Pediatr&#237;a"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "An Pediatr &#40;Barc&#41;. 2023;99:102-10"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:14 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
      "titulo" => "Prevalence of gastrointestinal symptoms in autism spectrum disorder&#58; A meta-analysis"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:3 [
        0 => "en"
        1 => "en"
        2 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "102"
          "paginaFinal" => "110"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Prevalencia de s&#237;ntomas gastrointestinales en trastornos del espectro del autismo&#58; un metaan&#225;lisis"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 1
        "multimedia" => array:5 [
          "identificador" => "fig0035"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => false
          "mostrarDisplay" => true
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "fx1.jpeg"
              "Alto" => 753
              "Ancho" => 1333
              "Tamanyo" => 118863
            ]
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Isabel Lasheras, Matias Real-L&#243;pez, Javier Santab&#225;rbara"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "Isabel"
              "apellidos" => "Lasheras"
            ]
            1 => array:2 [
              "nombre" => "Matias"
              "apellidos" => "Real-L&#243;pez"
            ]
            2 => array:2 [
              "nombre" => "Javier"
              "apellidos" => "Santab&#225;rbara"
            ]
          ]
        ]
      ]
      "resumen" => array:1 [
        0 => array:3 [
          "titulo" => "Graphical abstract"
          "clase" => "graphical"
          "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall"><elsevierMultimedia ident="fig0035"></elsevierMultimedia></p></span>"
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S1695403323001248"
        "doi" => "10.1016/j.anpedi.2023.05.011"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403323001248?idApp=UINPBA00005H"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S234128792300159X?idApp=UINPBA00005H"
    "url" => "/23412879/0000009900000002/v2_202403140552/S234128792300159X/v2_202403140552/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S2341287923001527"
    "issn" => "23412879"
    "doi" => "10.1016/j.anpede.2023.04.012"
    "estado" => "S300"
    "fechaPublicacion" => "2023-08-01"
    "aid" => "3454"
    "copyright" => "Asociaci&#243;n Espa&#241;ola de Pediatr&#237;a"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "An Pediatr &#40;Barc&#41;. 2023;99:82-93"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:14 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
      "titulo" => "Spanish adaptation and validation of the empowerment of parents in the intensive care-neonatology &#40;EMPATHIC-N&#41; questionnaire"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:3 [
        0 => "en"
        1 => "en"
        2 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "82"
          "paginaFinal" => "93"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Adaptaci&#243;n y validaci&#243;n espa&#241;ola del <span class="elsevierStyleItalic">Empowerment of Parents in the Intensive Care-Neonatology</span> &#40;EMPATHIC-N&#41;"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 1
        "multimedia" => array:5 [
          "identificador" => "fig0005"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => false
          "mostrarDisplay" => true
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "fx1.jpeg"
              "Alto" => 775
              "Ancho" => 1333
              "Tamanyo" => 158581
            ]
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Cristina Ruiz-Gonz&#225;lez, Patricia Mart&#237;n-Casas, Jos M&#46; Latour, Ana &#218;beda-Tikkanen, Ibai L&#243;pez-de-Uralde-Villanueva, Susana S&#225;nchez-Aparicio Garc&#237;a, Natalia Cuadrado-Obreg&#243;n"
          "autores" => array:7 [
            0 => array:2 [
              "nombre" => "Cristina"
              "apellidos" => "Ruiz-Gonz&#225;lez"
            ]
            1 => array:2 [
              "nombre" => "Patricia"
              "apellidos" => "Mart&#237;n-Casas"
            ]
            2 => array:2 [
              "nombre" => "Jos M&#46;"
              "apellidos" => "Latour"
            ]
            3 => array:2 [
              "nombre" => "Ana"
              "apellidos" => "&#218;beda-Tikkanen"
            ]
            4 => array:2 [
              "nombre" => "Ibai"
              "apellidos" => "L&#243;pez-de-Uralde-Villanueva"
            ]
            5 => array:2 [
              "nombre" => "Susana"
              "apellidos" => "S&#225;nchez-Aparicio Garc&#237;a"
            ]
            6 => array:2 [
              "nombre" => "Natalia"
              "apellidos" => "Cuadrado-Obreg&#243;n"
            ]
          ]
        ]
      ]
      "resumen" => array:1 [
        0 => array:3 [
          "titulo" => "Graphical abstract"
          "clase" => "graphical"
          "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall"><elsevierMultimedia ident="fig0005"></elsevierMultimedia></p></span>"
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S1695403323001157"
        "doi" => "10.1016/j.anpedi.2023.04.010"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403323001157?idApp=UINPBA00005H"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287923001527?idApp=UINPBA00005H"
    "url" => "/23412879/0000009900000002/v2_202403140552/S2341287923001527/v2_202403140552/en/main.assets"
  ]
  "en" => array:20 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
    "titulo" => "Nutritional support in the critical ill patient&#58; Requirements&#44; prescription and adherence"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "94"
        "paginaFinal" => "101"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Camila Vergara, Paulina del Pozo, Jessie Niklitschek, Catalina Le Roy"
        "autores" => array:4 [
          0 => array:3 [
            "nombre" => "Camila"
            "apellidos" => "Vergara"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Paulina"
            "apellidos" => "del Pozo"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Jessie"
            "apellidos" => "Niklitschek"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          3 => array:4 [
            "nombre" => "Catalina"
            "apellidos" => "Le Roy"
            "email" => array:1 [
              0 => "catalinaleroy@yahoo.es"
            ]
            "referencia" => array:3 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
              2 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:3 [
          0 => array:3 [
            "entidad" => "Departamento de Gastroenterolog&#237;a y Nutrici&#243;n Pedi&#225;trica&#44; Divisi&#243;n de Pediatr&#237;a&#44; Escuela de Medicina Pontificia Universidad Cat&#243;lica de Chile&#44; Santiago&#44; Chile"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Unidad Acad&#233;mica de Cuidados Intensivos Pedi&#225;tricos&#44; Departamento de Pediatr&#237;a&#44; Divisi&#243;n de Pediatr&#237;a&#44; Escuela de Medicina Pontificia Universidad Cat&#243;lica de Chile&#44; Santiago&#44; Chile"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Departamento de Pediatr&#237;a y Cirug&#237;a Infantil&#44; Campus Centro&#44; Facultad de Medicina&#44; Universidad de Chile&#44; Santiago&#44; Chile"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Soporte nutricional en el paciente cr&#237;tico&#58; requerimiento&#44; prescripci&#243;n y cumplimiento"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 1
      "multimedia" => array:5 [
        "identificador" => "fig0015"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx1.jpeg"
            "Alto" => 750
            "Ancho" => 1333
            "Tamanyo" => 153542
          ]
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">The nutritional support of critically ill patients continues to be a challenge for the care team&#46; It is difficult to estimate the requirements of these patients&#44; select the route of delivery and assess adherence due to the characteristics of medically complex patients&#44; who experience shifting disease dynamics and metabolic stress that further complicate the delivery of nutritional support&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Critical illness is conceived as having three phases&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> The acute phase may last from hours to days&#44; during which the main goal of treatment is to maintain the functions of vital organs&#44; and is characterised&#44; among other features&#44; by an increase in inflammation&#44; the involvement of counterregulatory hormones&#44; protein and fatty acid catabolism and peripheral inactivation of thyroid hormones and insulin-like growth factor 1 &#40;IGF1&#41;&#46; It is followed by the stable phase&#44; characterised by stabilization or weaning of vital organ support&#44; which lasts from a few days to weeks&#46; Last of all&#44; there is the recovery phase&#44; during which metabolic&#44; endocrine and immunological disturbances normalise and protein anabolism increases&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Depending on the phase of illness&#44; there are changes in energy<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> and protein requirements and enteral tolerance&#44;<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#44;6</span></a> haemodynamics and fluid and electrolyte balance in addition to metabolic and endocrine changes&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">International guidelines agree that energy requirements during the acute phase of illness should be calculated by means of indirect calorimetry or&#44; if not available&#44; the factorial method &#40;Schofield equation&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">8&#44;9</span></a> One meta-analysis estimated that the Schofield equation&#44; whether using only the weight or both the weight and the height&#44; could predict the basal metabolic rate &#40;BMR&#41; with an error of &#177;15&#37;&#46;<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10&#44;11</span></a> When it comes to protein&#44; current guidelines recommend guaranteeing an intake of at least 1&#46;5 g of protein per day during the acute phase&#46;<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">8&#44;12&#44;13</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Delivering adequate nutritional support in this clinical context is challenging&#44; and malnutrition is a frequent problem in critically ill paediatric patients&#46; On one hand&#44; providing an excessive amount of nutrients may lead to overfeeding&#44; which carries a risk of cellular damage and metabolic disturbances&#44;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> while an insufficient intake is associated with increases in morbidity&#44; mortality and length of stay&#46;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;15&#44;16</span></a> Insufficient nutrient delivery is usually due to either prescribing of insufficient doses or poor adherence&#46;<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">17&#44;18</span></a> There are many reasons that may contribute to inadequate adherence to prescribed nutrition&#44; which may be related to the phase of illness&#59; changes in gastrointestinal motility are more frequent during the acute phase&#44; as are haemodynamic&#44; metabolic and endocrine changes&#46; This determines the number of required procedures&#44; the need of fluid restriction etc&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a> which&#44; in plain terms&#44; are associated with an increase in the number of interruptions and decrease in adherence to prescribed nutrition&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> There is substantial variability between previous studies in the reported nutrients delivered in relation to the nutrients prescribed&#44; ranging from 25&#37; to 59&#37; of the prescribed energy intake and 32&#46;7&#37;&#8211;93&#46;6&#37; of the prescribed protein intake&#44;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;11&#44;20&#8211;22</span></a> depending on the population under study&#44; the expertise of the care time&#44; the estimated time elapsed to achievement of nutritional goals&#44; the availability of systems to monitor nutrition&#44; the use of protocols and the severity of disease&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;16&#44;23&#44;24</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The aim of our study was to assess the association between prescribing&#44; requirements and adherence with nutritional support&#44; specifically the energy and protein intake&#44; based on the phase of disease in critically ill paediatric patients&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Sample and methods</span><p id="par0025" class="elsevierStylePara elsevierViewall">We conducted a prospective observational descriptive and analytical study&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">We included patients aged 0&#8211;18 years admitted for a minimum of 24 h to the paediatric intensive and intermediate care unit of the Hospital Cl&#237;nico of the Pontificia Universidad Cat&#243;lica between August 2020 and January 2021&#46; We excluded patients predominantly fed by the oral route&#44; defined as receiving more than 70&#37; of prescribed nutrition through this route&#44; and patients admitted for an elective procedure for multidisciplinary assessment in the absence of acute illness&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">For the total study period&#44; we selected 3 days per month at random using Excel&#46; The principal investigator collected the data for the past 24 h by reviewing the medical and nursing records for the patients&#46; This amounted to a total of 18 days of data&#44; which were then anonymised and coded for subsequent analysis&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">The study was exploratory and the patients were selected by convenience sampling&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">We collected data on the following variables&#58; sex&#44; age &#40;in complete months&#41;&#44; weight &#40;kg&#41; and height &#40;cm&#41; at admission&#44; diagnosis at admission &#40;respiratory&#44; cardiovascular&#44; neurologic&#44; infectious&#44; trauma&#47;orthopaedics&#44; haematological&#47;oncological&#44; postsurgical&#44; other&#41;&#44; comorbidity &#40;yes&#47;no&#59; defined as the presence of any disease concomitant to the primary diagnosis at admission&#41; and type of comorbidity &#40;respiratory&#44; cardiovascular&#44; neurologic&#44; infectious&#44; trauma&#47;orthopaedics&#44; haematological&#47;oncological&#44; postsurgical&#44; other&#41;&#46; The nutritional status of the patient was assessed using the 2006 World Health Organization &#40;WHO&#41; child growth standards for children aged 0&#8211;5 years<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a> and the 2007 WHO growth reference data for children aged 5&#8211;18 years<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a> as reference&#44; in adherence with current domestic guidelines&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">27</span></a> In the case of patients with Down syndrome&#44; we used the weight &#40;Wt&#41;-for-age and height &#40;Ht&#41;-for-age growth charts published by Zemel et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">28</span></a> in addition to the WHO weight-for-height and body mass index &#40;BMI&#41;-for-age charts for children aged more than 5 years to diagnose excess weight&#46; For patients with cerebral palsy&#44; we used the growth charts of Brooks et al&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a> adjusted according to the Gross Motor Function Classification System &#40;GMFCS&#41; for the Wt-for-age and Ht-for-age&#46; Based on the Wt-for-age distribution&#44; we defined undernutrition as a weight below the 10th percentile &#40;P10&#41;&#44; risk of undernutrition as a weight between the P10 and the 25th percentile &#40;P25&#41;&#44; adequate nutrition as a weight between the P25 and the 75th percentile &#40;P75&#41;&#44; overweight as a weight between the P75 and the 95th percentile &#40;P95&#41; and obesity as a weight above the P95&#46;We defined short stature as a height at or below the P10 in the Zemel and Brooks growth charts&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The basal metabolic rate was calculated with the Schofield equation using the weight or the weight and height&#46; We obtained the prescribed amounts of energy and protein from the prescription issued by the treating physician and the actual amount of delivered nutrition &#40;adherence&#41; from the nursing records&#44; expressed as kcal&#47;kg&#47;day and grams of protein&#47;kg&#47;day&#46; We recorded the total nutrient intake&#44; regardless of the route of delivery&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">We calculated the following ratios&#58; prescribed nutrition&#47;BMR &#40;P&#47;BMR&#41;&#44; delivered nutrition &#40;adherence&#41;&#47;BMR &#40;A&#47;BMR&#41;&#44; delivered nutrition &#40;adherence&#41;&#47;prescribed nutrition &#40;A&#47;P&#41;&#46; We classified the energy intake as underfeeding &#40;&#60;90&#37;&#41;&#44; adequate nutrition &#40;90&#37;&#8211;110&#37;&#41; or overfeeding &#40;&#62;110&#37;&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a> For protein&#44; we classified intake as inadequate &#40;&#60;1&#46;5 g protein&#47;kg&#47;day&#41; or adequate &#40;&#8805;1&#46;5 g protein&#47;kg&#47;day&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">8&#44;12&#44;13</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">We recorded the route of administration &#40;oral&#44; enteral&#44; parenteral&#41;&#44; the enteral feeding method &#40;bolus&#44; continuous feeding&#41;&#44; any suspensions of nutritional support and the reason for the suspension &#40;procedure involving airway management&#44; gastrointestinal dysfunction&#44; diagnostic procedure&#44; mechanical problem&#41;&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">We classified the phase of illness as acute or non-acute based on a checklist designed by the research team that took into account different physiological variables and classification criteria by disease by system&#44; defining acute illness as meeting one or more of the criteria in the list &#40;Appendix A&#44; Supplemental material 1&#41;&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Ethical considerations</span><p id="par0070" class="elsevierStylePara elsevierViewall">The study adhered to the principles of the Declaration of Helsinki&#46; The study was approved by the Health Sciences Scientific and Ethics Committee of the School of Medicine of Pontificia Universidad Cat&#243;lica de Chile &#40;no&#46; 200122005&#41; and considered exempt from the need of informed consent&#44; given its observational nature and that contact with patients or families was not required to collect the necessary data&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Statistical analysis</span><p id="par0075" class="elsevierStylePara elsevierViewall">The statistical analyses were carried out with the following software packages&#58; STATA version 13&#44; prism version 9&#46;0&#44; SPSS version 28&#46;0&#46;1&#46;0&#46; We summarised categorical variables as absolute and relative frequencies&#46; We used the Shapiro&#8211;Wilk test to analyse the distribution of continuous variables&#44; which were summarised as median and interquartile range &#40;IQR&#41;&#46; To compare the prescription&#44; delivery &#40;adherence&#41; and BMR ratios in the acute and non-acute phases of disease&#44; we carried out an inferential analysis using the &#967;<span class="elsevierStyleSup">2</span> test or Fisher exact test&#44; as applicable&#44; and the Wilcoxon test&#46; We calculated the Spearman correlation coefficient for the P&#47;BMR ratios for energy intake and protein intake&#46; We considered <span class="elsevierStyleItalic">P</span> values of less than 0&#46;05 statistically significant&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Results</span><p id="par0080" class="elsevierStylePara elsevierViewall">The sample included 131 patients &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> presents their demographic characteristics and nutritional data&#41;&#46; The nutritional status could be determined in 116 patients&#44; and a full nutritional evaluation was possible in 94 patients for whom weight and height data were available&#46; Out of the total sample&#44; 9 patients had GMFCS level V cerebral palsy and 12 had Down syndrome&#46; Of note&#44; 32&#46;8&#37; had undernutrition and 36&#46;6&#37; had adequate nutrition&#46; The predominant feeding modality was exclusive enteral nutrition &#40;77&#46;1&#37;&#41;&#44; and the most frequent reason for suspension of nutritional support was performance of an invasive procedure&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">The BMR was calculated with the weight Schofield equation in 39 patients &#40;29&#46;77&#37;&#41; and the weight-height Schofield equation in 92 &#40;70&#46;23&#37;&#41;&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Among the patients managed with enteral feeding&#44; nutrition was delivered through a gastrostomy tube in 24 &#40;21&#46;1&#37;&#41;&#44; through a nasogastric tube in 76 &#40;66&#46;7&#37;&#41;&#44; and through a nasojejunal tube in 14 &#40;12&#46;3&#37;&#41;&#46; The enteral feeding modality was bolus feeding in 67 patients &#40;58&#46;8&#37;&#41; and continuous feeding in 47 patients &#40;41&#46;2&#37;&#41;&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> presents the ratios of energy and protein intake requirements&#44; amounts prescribed and amounts delivered &#40;adherence&#41; in the total sample and by phase of illness&#46; We found a correlation coefficient of 0&#46;6 for the association between the energy P&#47;BMR and the protein prescription&#47;protein requirements &#40;R&#41; &#40;P&#47;R&#41;&#44; and no correlation between the protein requirement&#47;delivery &#40;adherence&#41; and the A&#47;P&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall"> presents the distribution of underfeeding&#44; adequate nutrition and overfeeding based on the energy intake for each of the ratios under study &#40;P&#47;BMR&#44; A&#47;BMR and A&#47;P&#41;&#44; and we found a statistically significant difference &#40;<span class="elsevierStyleItalic">P</span> &#60; 0&#46;00001&#41; on account of overfeeding for all ratios&#46; <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> presents the distribution by phase of disease &#40;acute vs&#46; non-acute&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a> presents the distribution of prescribed and delivered protein in the total sample and by phase of illness&#44; and the most salient findings were the prescription of more than 1&#46;5 g of protein&#47;kg&#47;day in 56&#46;5&#37; of the sample and the adherence to the prescription in 51&#46;9&#37;&#46; We found significant differences between the prescribed amount and the delivered amount &#40;adherence&#41; in the groups with prescriptions of more or less than 1&#46;5 g de protein&#47;kg&#47;day by phase of disease &#40;Fisher test <span class="elsevierStyleItalic">P</span> &#61; 0&#46;016 and <span class="elsevierStyleItalic">P</span> &#61; 0&#46;007&#44; respectively&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a> compares the energy P&#47;BMR&#44; A&#47;P and A&#47;BMR by phase of illness&#44; showing that the ratios were higher in non-acute patients&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0115" class="elsevierStylePara elsevierViewall">The analysis of the variables associated with adherence to the prescribed energy intake revealed a higher frequency of underfeeding compared to the prescribed amount in patients at risk of undernutrition &#40;7&#47;10&#41; &#40;<span class="elsevierStyleItalic">P</span> &#61; 0&#46;001&#41;&#46; On the other hand&#44; eutrophic patients and patients with excess malnutrition have adherence of the prescription of 90-110&#37; &#40;adequate&#41; with greater frequency &#40;45&#47;73&#41; &#40;p &#61; 0&#46;001&#41;&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Most patients in the acute phase of illness &#40;9&#47;13&#41; were underfed compared to the prescribed nutrition &#40;&#60;90&#37;&#41;&#46; In contrast&#44; in the non-acute group&#44; adherence was adequate &#40;90&#37;&#8211;110&#37;&#41; in most patients &#40;78&#47;118&#41;&#46; A small number &#40;3&#47;118&#41; even received more than was prescribed &#40;&#62;110&#37;&#41; &#40;<span class="elsevierStyleItalic">P</span> &#61; 0&#46;007&#41;&#46; We did not find statistically significant differences in the frequency distribution of acute vs&#46; non-acute patients by reason for suspension of nutritional therapy &#40;<span class="elsevierStyleItalic">P</span> &#61; 0&#46;074&#41; or type of nutritional support &#40;<span class="elsevierStyleItalic">P</span> &#61; 0&#46;237&#41;&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Discussion</span><p id="par0125" class="elsevierStylePara elsevierViewall">Several reports indicate that the protein and energy requirements of patients admitted to intensive care units are frequently not met &#40;A&#47;R and A&#47;BMR&#41; during the acute phase of illness&#46;<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">18&#44;19&#44;22&#44;24</span></a></p><p id="par0130" class="elsevierStylePara elsevierViewall">In our study&#44; we found that three fifths of patients had an energy intake meeting their BMR and half had a protein intake meeting their protein requirements &#40;A&#47;R&#41;&#44; with a higher proportion of patients with intakes meeting the BMR in the non-acute versus the acute phase of illness&#44; in agreement with previous studies that found that delivery of the full required amount was harder in the early days of the intensive care unit stay&#44; which usually correspond to the acute phase&#46;<a class="elsevierStyleCrossRefs" href="#bib0115"><span class="elsevierStyleSup">23&#44;30&#44;31</span></a></p><p id="par0135" class="elsevierStylePara elsevierViewall">A noteworthy finding in our study was that the percentage of patients in the acute phase of illness was low for the paediatric critical care setting&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">In the assessment of the prescribed energy intake&#44; based on the widespread consensus for the optimal nutrition of paediatric patients&#44; with calculation of the BMR by means of the Schofield equation&#44;<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">8&#44;12</span></a> we found that only a small percentage of patients had an adequate energy intake prescription &#40;P&#47;BMR&#41;&#44; with an insufficient or excessive prescription in most patients&#44; more frequently the latter&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Given that the acute phase of illness is characterised by ongoing changes in metabolism&#44; the Schofield formula used in isolation cannot account for changes in metabolism following injury and can overestimate energy requirements&#44; as observed by Mehta et al&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">32</span></a> in a study in which they compared indirect calorimetry measurements with these equations&#44; highlighting the overestimation of energy requirements using equations due to hypometabolism in these patients&#46; Other studies&#44; like the one conducted by Oosterveld et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">33</span></a> have not found significant differences between the calculation of the resting energy expenditure rate using indirect calorimetry and the Schofield equation&#44; which reinforces what we have noted above&#44; that energy requirements in these patients can be underestimated as well as overestimated&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">In the assessment by phase of illness&#44; we found that the median prescribed energy intake in patients in the acute phase was approximately half the BMR &#40;P&#47;BMR&#41;&#44; similar to the findings of studies like the one published by De Jonghe et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> who reported prescriptions of 78&#37; of the energy requirements in these patients&#44; or the study by McClave et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">34</span></a> who reported prescription of 65&#46;6&#37; of the estimated requirements&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">It is well known that critical illness is associated with protein catabolism&#44; which has a negative impact in terms of an increase in both morbidity and mortality and a more difficult recovery&#46;<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">13&#44;35</span></a> When we analysed the prescribed protein intake in relation to the protein requirements &#40;P&#47;R&#41; and the adherence to this prescription&#44; we found that in most patients the prescribed and actual intakes adhered to current recommendations&#44;<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">8&#44;12&#44;13</span></a> with greater adherence compared to other studies&#59; thus&#44; Kyle et al&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a> reported a protein intake of 40&#46;4&#37; of the protein requirements and Wong et al&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">36</span></a> an intake of only 13&#46;1&#37; of estimated requirements on day 3 of the intensive care unit stay&#46; We must underscore the importance of delivering nutrition consistent with current recommendations to avoid malnutrition and a negative protein balance&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">37</span></a> In the group of patients with acute illness&#44; we found that 23&#37; had prescriptions for less than 1&#46;5 g of protein per kg of body weight&#44; which was consistent with the studies cited above&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">When we assessed adherence with the prescribed energy intake &#40;A&#47;P&#41;&#44; we found that one third of the patients were underfed&#44; a proportion that was lower than reported by De Jonghe et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> who found that 90&#46;1&#37; of the amount prescribed was delivered&#44; and Li et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a> who found a percentage of underfeeding of 85&#37;&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">It is worth noting that patients in the acute metabolic stress phase only achieved two thirds of the prescribed intake for both energy and protein&#46; When we explored the variables that may have played a role in this outcome&#44; we found that most patients who did not achieve a delivered&#47;prescribed ratio greater than 90&#37; had experienced interruptions to nutritional support&#44; and invasive&#44; non-invasive procedures and airway management procedures accounted for more than half of the interruptions&#46; In addition&#44; we found that suspensions of nutritional support were more frequent in patients at risk of undernutrition&#44; although we were able to determine the cause or find an association with any of the variables under study that could explain it&#46; This is an important finding&#44; as these patients would be more likely to eventually become undernourished&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">Our findings evince the substantial proportion of critically ill paediatric patients whose intake does not meet their nutritional requirements for either energy or protein&#46; The values observed in our study were greater compared to other studies in the literature&#44; which in our opinion highlights the importance of implementing standardised nutritional support protocols for critical patients and a multidisciplinary approach to their management with the aim of improving these outcomes&#44; which could be subject to study in the future&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a></p><p id="par0175" class="elsevierStylePara elsevierViewall">There are limitations to our study&#44; chief of which is that it was conducted in the context of the coronavirus disease 2019 pandemic&#44; which changed the epidemiology of acute illness in the paediatric population and&#44; as a result&#44; the reasons for admission to the paediatric intensive care unit&#46; Another limitation was the low proportion of patients in the acute phase of illness&#44; which was defined based on the fulfilment of criteria in a checklist developed by the research team&#44; since no existing instruments for the purpose were found&#44; and which precluded comparisons to determine whether this low frequency would be expected in this type of paediatric unit&#46; We did not collect data on the length of stay in the hospital and in the paediatric intensive care or intermediate care units or the duration of nutritional support to provide a more detailed interpretation of the results&#46; Last of all&#44; we did not compare the estimated energy requirements with values obtained by indirect calorimetry &#40;the gold standard&#41; or estimated protein requirements with the nitrogen balance to carry out the analyses&#44; which would have allowed a more accurate assessment of individual requirements&#46; One of the strengths of the study is that we integrated the phase of illness in the analysis in relation to the estimated BMR&#44; the prescribed nutrition and the amounts that could actually be delivered&#44; a novel approach that provides a more thorough understanding of the timing&#44; amount and route of delivery of nutritional support in children in the intensive care unit based on the deficiencies or excesses in the nutrition that is actually delivered&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Conclusion</span><p id="par0180" class="elsevierStylePara elsevierViewall">In the sample of patients managed in the paediatric intensive and intermediate care unit&#44; we found that the prescribed intake in relation to the BMR was appropriate in a high proportion of patients in the non-acute phase of disease&#44; doubling the proportion with adequate prescription of energy intake and more than tripling the proportion with adequate prescription of protein intake in the group of patients in the acute phase of illness&#46; Intake was lower in patients in the acute phase of illness&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">In relation to this&#44; our findings illustrated the difficulty in achieving delivery of the total prescribed intake&#44; and one of the main reasons for it was the frequent interruption of nutritional support&#44; chiefly in relation to the performance of invasive procedures&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">On the other hand&#44; overfeeding was frequent&#44; more so in the non-acute phase of disease&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">Our findings illustrate the challenge of providing balanced nutritional support to critically ill paediatric patients&#44; which requires ongoing evaluation through objective clinical parameters to assess the impact of prescribed nutrition in relation to the BMR&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Funding</span><p id="par0200" class="elsevierStylePara elsevierViewall">This research did not receive any external funding&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conflicts of interest</span><p id="par0205" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:13 [
        0 => array:3 [
          "identificador" => "xres2107130"
          "titulo" => "Graphical abstract"
          "secciones" => array:1 [
            0 => array:1 [
              "identificador" => "abst0005"
            ]
          ]
        ]
        1 => array:3 [
          "identificador" => "xres2107131"
          "titulo" => "Abstract"
          "secciones" => array:5 [
            0 => array:2 [
              "identificador" => "abst0010"
              "titulo" => "Introduction"
            ]
            1 => array:2 [
              "identificador" => "abst0015"
              "titulo" => "Objective"
            ]
            2 => array:2 [
              "identificador" => "abst0020"
              "titulo" => "Sample and methods"
            ]
            3 => array:2 [
              "identificador" => "abst0025"
              "titulo" => "Results"
            ]
            4 => array:2 [
              "identificador" => "abst0030"
              "titulo" => "Conclusions"
            ]
          ]
        ]
        2 => array:2 [
          "identificador" => "xpalclavsec1795305"
          "titulo" => "Keywords"
        ]
        3 => array:3 [
          "identificador" => "xres2107129"
          "titulo" => "Resumen"
          "secciones" => array:5 [
            0 => array:2 [
              "identificador" => "abst0035"
              "titulo" => "Introducci&#243;n"
            ]
            1 => array:2 [
              "identificador" => "abst0040"
              "titulo" => "Objetivo"
            ]
            2 => array:2 [
              "identificador" => "abst0045"
              "titulo" => "Pacientes y m&#233;todo"
            ]
            3 => array:2 [
              "identificador" => "abst0050"
              "titulo" => "Resultados"
            ]
            4 => array:2 [
              "identificador" => "abst0055"
              "titulo" => "Conclusiones"
            ]
          ]
        ]
        4 => array:2 [
          "identificador" => "xpalclavsec1795304"
          "titulo" => "Palabras clave"
        ]
        5 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        6 => array:3 [
          "identificador" => "sec0010"
          "titulo" => "Sample and methods"
          "secciones" => array:2 [
            0 => array:2 [
              "identificador" => "sec0015"
              "titulo" => "Ethical considerations"
            ]
            1 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "Statistical analysis"
            ]
          ]
        ]
        7 => array:2 [
          "identificador" => "sec0025"
          "titulo" => "Results"
        ]
        8 => array:2 [
          "identificador" => "sec0030"
          "titulo" => "Discussion"
        ]
        9 => array:2 [
          "identificador" => "sec0035"
          "titulo" => "Conclusion"
        ]
        10 => array:2 [
          "identificador" => "sec0040"
          "titulo" => "Funding"
        ]
        11 => array:2 [
          "identificador" => "sec0045"
          "titulo" => "Conflicts of interest"
        ]
        12 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2022-09-27"
    "fechaAceptado" => "2023-05-22"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1795305"
          "palabras" => array:6 [
            0 => "Critical care"
            1 => "Nutritional requirements"
            2 => "Stress response"
            3 => "Nutritional support"
            4 => "Critical illness"
            5 => "Overfeeding"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec1795304"
          "palabras" => array:6 [
            0 => "Cuidados cr&#237;ticos"
            1 => "Requerimiento nutricional"
            2 => "Respuesta al estr&#233;s"
            3 => "Soporte nutricional"
            4 => "Enfermedad cr&#237;tica"
            5 => "Sobrealimentaci&#243;n pedi&#225;trica"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Introduction</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">In critically ill patients&#44; nutritional support is a challenge in terms of both estimating their requirements and ensuring adherence to the prescribed treatment&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Objective</span><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">To assess the association between requirements&#44; prescription and adherence to energy and protein supplementation based on the phase of disease in critically ill patients&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Sample and methods</span><p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">We conducted a prospective&#44; observational and analytical study in patients aged 0&#8211;18 years admitted to the paediatric intensive or intermediate care unit in 2020&#8211;2021&#46; We collected data on demographic and anthropometric characteristics and the phase of disease &#40;acute phase &#91;AP&#93; vs&#46; non-acute phase &#91;nAP&#93;&#41;&#44; in addition to prescribing &#40;P&#41; &#40;indication of nutritional support&#41;&#44; basal metabolic rate &#40;BMR&#44; Schofield equation&#41;&#44; adherence to nutritional support &#40;A&#41; and protein requirements &#40;R&#41;&#44; and calculated the following ratios&#58; P&#47;BMR&#44; P&#47;R&#44; A&#47;BMR&#44; A&#47;R&#44; and A&#47;P&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Results</span><p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">The sample included 131 participants with a median age of 16 &#40;4&#46;5&#41; months&#44; of who 128 &#40;97&#46;7&#37;&#41; had comorbidities and 13 &#40;9&#46;9&#37;&#41; were in the AP&#46; Comparing the phases of disease &#40;AP vs&#46; nAP&#41;&#44; the median values for energy supplementation were P&#47;BMR&#44; 0&#46;5 &#40;IQR&#44; 0&#46;1&#8211;1&#46;4&#41; vs&#46; 1&#46;3 &#40;IQR&#44; 0&#46;9&#8211;1&#46;8&#41; &#40;<span class="elsevierStyleItalic">P</span> &#61; 0&#46;0054&#41;&#59; A&#47;BMR&#44; 0&#46;4 &#40;IQR&#44; 0&#8211;0&#46;6&#41; vs&#46; 1&#46;2 &#40;IQR&#44; 0&#46;8&#8211;1&#46;7&#41; &#40;<span class="elsevierStyleItalic">P</span> &#61; 0&#46;0005&#41;&#59; A&#47;P&#44; 0&#46;7 &#40;IQR&#44; 0&#8211;0&#46;9&#41; vs&#46; 1 &#40;IQR&#44; 0&#46;8&#8211;1&#41; &#40;<span class="elsevierStyleItalic">P</span> &#61; 0&#46;002&#41;&#44; and for protein were P&#47;R&#44; 0&#46;7 &#40;IQR&#44; 0&#8211;1&#46;1&#41; vs&#46; 1&#46;2 &#40;0&#46;9&#8211;1&#46;6&#41; &#40;<span class="elsevierStyleItalic">P</span> &#61; 0&#46;0009&#41;&#59; A&#47;R 0&#46;3 &#40;IQR&#44; 0&#8211;0&#46;6&#41; vs&#46; 1&#46;1 &#40;IQR&#44; 0&#46;8&#8211;1&#46;5&#41; &#40;<span class="elsevierStyleItalic">P</span> &#61; 0&#46;0002&#41;&#59; A&#47;P 0&#46;7 &#40;IQR&#44; 0&#8211;1&#41; vs&#46; 1&#40;IQR&#44; 0&#46;8&#8211;1&#41; &#40;<span class="elsevierStyleItalic">P</span> &#61; 0&#46;002&#41;&#46; We found AP&#47;nAP ratios greater than 110&#37; for energy in the P&#47;BMR &#40;4 patients &#91;30&#46;8&#37;&#93;&#47;72 patients &#91;61&#37;&#93;&#59; <span class="elsevierStyleItalic">P</span> &#61; 0&#46;007&#41;&#44; A&#47;BMR &#40;3 &#91;23&#37;&#93;&#47;63 &#91;53&#46;4&#37;&#93;&#59; <span class="elsevierStyleItalic">P</span> &#61; 0&#46;009&#41; and A&#47;P &#40;1 &#91;7&#37;&#93;&#47;3 &#91;2&#46;5&#37;&#93;&#59; <span class="elsevierStyleItalic">P</span> &#61; 0&#46;007&#41;&#46; As for protein&#44; more than 1&#46;5 g&#47;kg&#47;day was prescribed in 3 patients &#40;23&#46;1&#37;&#41; in the AP and 71 &#40;60&#46;1&#37;&#41; in the nAP&#46; We found adherence to the prescribed intake in 2 &#40;15&#46;4&#37;&#41; patients in the AP and 66 &#40;56&#37;&#41; in the nAP&#46; We found a correlation coefficient of 0&#46;6 between the energy P&#47;R and the protein P&#47;R&#46; Prescribed support was discontinued in 7 patients &#40;53&#46;8&#37;&#41; in the AP and 31 &#40;26&#46;3&#37;&#41; in the nAP &#40;<span class="elsevierStyleItalic">P</span> &#61; 0&#46;002&#41;&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conclusions</span><p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">The proportion of adherence to prescribed nutritional support was high in patients in the nAP of the disease&#46; Overfeeding was frequent&#44; more so in the nAP&#46; We identified difficulties in adhering to prescribed support&#44; chief of which was the discontinuation of feeding&#46;</p></span>"
        "secciones" => array:5 [
          0 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Introduction"
          ]
          1 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Objective"
          ]
          2 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Sample and methods"
          ]
          3 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Results"
          ]
          4 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Conclusions"
          ]
        ]
      ]
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Introducci&#243;n</span><p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">El soporte nutricional en el paciente cr&#237;tico es un desaf&#237;o tanto en la estimaci&#243;n de requerimientos como en el cumplimiento de su prescripci&#243;n&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Objetivo</span><p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">Evaluar las relaciones entre la prescripci&#243;n&#44; el requerimiento y el cumplimiento del soporte nutricional de energ&#237;a y prote&#237;nas seg&#250;n la fase de la enfermedad en el paciente cr&#237;tico&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Pacientes y m&#233;todo</span><p id="spar0110" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional&#44; anal&#237;tico&#44; de datos obtenidos a trav&#233;s de reclutamiento prospectivo &#40;2020&#8211;2021&#41;&#44; pacientes de 0&#8211;18 a&#241;os hospitalizados en la unidad de cuidados intensivos o intermedios pedi&#225;trica&#46; Se obtuvieron datos demogr&#225;ficos&#44; antropom&#233;tricos y del estado agudo &#40;FA&#41;&#47;no agudo &#40;FNA&#41; de la enfermedad&#46; Se determinaron la prescripci&#243;n &#40;P&#41; &#40;indicaci&#243;n nutricional&#41;&#44; el gasto energ&#233;tico basal &#40;GEB&#41; &#40;f&#243;rmula de Schofield&#41;&#44; el cumplimiento &#40;C&#41; de soporte nutricional&#44; el requerimiento &#40;R&#41; proteico&#44; cre&#225;ndose las siguientes relaciones&#58; P&#47;GEB&#44; P&#47;R&#44; C&#47;GEB&#44; C&#47;R&#44; C&#47;P&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Resultados</span><p id="spar0115" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron 131 sujetos con una mediana de 16 &#40;4&#44;5&#41; meses&#59; el 97&#44;7&#37; presentaban alguna comorbilidad y el 9&#44;9&#37; cursaban en FA&#46; Al comparar FA&#47;FNA tuvieron mediana &#40;RIC&#41; de energ&#237;a&#58; P&#47;GEB 0&#44;5 &#40;0&#44;1&#8211;1&#44;4&#41;&#47;1&#44;3 &#40;0&#44;9&#8211;1&#44;8&#41; &#40;p &#61; 0&#44;0054&#41;&#59; C&#47;GEB 0&#44;4 &#40;0&#8211;0&#44;6&#41;&#47;1&#44;2 &#40;0&#44;8&#8211;1&#44;7&#41; &#40;p &#61; 0&#44;0005&#41;&#59; C&#47;P 0&#44;7 &#40;0&#8211;0&#44;9&#41;&#47;1 &#40;0&#44;8&#8211;1&#41; &#40;p &#61; 0&#44;002&#41;&#46; Y prote&#237;nas&#58; P&#47;R 0&#44;7 &#40;0&#8211;1&#44;1&#41;&#47;1&#44;2 &#40;0&#44;9&#8211;1&#44;6&#41; &#40;p &#61; 0&#44;0009&#41;&#59; C&#47;R 0&#44;3 &#40;0&#8211;0&#44;6&#41;&#47;1&#44;1 &#40;0&#44;8&#8211;1&#44;5&#41; &#40;p &#61; 0&#44;0002&#41;&#59; C&#47;P 0&#44;7 &#40;0&#8211;1&#41;&#47;1 &#40;0&#44;8&#8211;1&#41; &#40;p &#61; 0&#44;002&#41;&#46; Se encontr&#243; para energ&#237;a FA&#47;FNA &#62; 110&#37; en P&#47;GEB en 4 pacientes &#40;30&#44;8&#37;&#41;&#47;72 &#40;61&#37;&#41; &#40;p &#61; 0&#44;007&#41;&#44; C&#47;GEB en 3 pacientes &#40;23&#37;&#41;&#47;63 &#40;53&#44;4&#37;&#41; &#40;p &#61; 0&#44;009&#41; y C&#47;P en 1 &#40;7&#37;&#41;&#47;3 &#40;2&#44;5&#37;&#41; &#40;p &#61; 0&#44;007&#41;&#46; En prote&#237;nas se prescribi&#243; &#62; 1&#44;5 g&#47;kg&#47;d&#237;a en 3 &#40;23&#44;1&#37;&#41; pacientes en FA y 71 &#40;60&#44;1&#37;&#41; en FNA&#46; El cumplimiento de este aporte fue de 2 &#40;15&#44;4&#37;&#41; pacientes en FA y 66 &#40;56&#37;&#41; en FNA&#46; Se encontr&#243; un coeficiente de correlaci&#243;n de 0&#44;6 entre P&#47;GEB de energ&#237;a con P&#47;R proteico&#46; La suspensi&#243;n fue de 7 &#40;53&#44;8&#37;&#41; pacientes en FA y 31 &#40;26&#44;3&#37;&#41; en FNA &#40;p &#61; 0&#44;002&#41;&#46;</p></span> <span id="abst0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Conclusiones</span><p id="spar0120" class="elsevierStyleSimplePara elsevierViewall">La relaci&#243;n de cumplimiento de la prescripci&#243;n fue alta en pacientes en FNA de la enfermedad&#46; La sobrealimentaci&#243;n fue frecuente&#44; siendo mayor en FNA&#46; Se observ&#243; dificultad para cumplir la prescripci&#243;n&#44; siendo la causa principal la suspensi&#243;n de la alimentaci&#243;n&#46;</p></span>"
        "secciones" => array:5 [
          0 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Introducci&#243;n"
          ]
          1 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Objetivo"
          ]
          2 => array:2 [
            "identificador" => "abst0045"
            "titulo" => "Pacientes y m&#233;todo"
          ]
          3 => array:2 [
            "identificador" => "abst0050"
            "titulo" => "Resultados"
          ]
          4 => array:2 [
            "identificador" => "abst0055"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
    ]
    "apendice" => array:1 [
      0 => array:1 [
        "seccion" => array:1 [
          0 => array:4 [
            "apendice" => "<p id="par0215" class="elsevierStylePara elsevierViewall">The following is Supplementary data to this article&#58;<elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>"
            "etiqueta" => "Appendix A"
            "titulo" => "Supplementary data"
            "identificador" => "sec0055"
          ]
        ]
      ]
    ]
    "multimedia" => array:8 [
      0 => array:8 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 992
            "Ancho" => 1675
            "Tamanyo" => 58392
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0020"
            "detalle" => "Figure "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Appropriateness of nutritional support based on the relationships between basal metabolic rate&#44; prescribed nutrition and delivered nutrition &#40;adherence&#41;&#46;</p> <p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A&#47;BMR&#58; adherence&#47;basal metabolic rate&#59; A&#47;P&#44; adherence&#47;prescribed&#59; P&#47;BMR&#44; prescribed&#47;basal metabolic rate&#46;</p>"
        ]
      ]
      1 => array:8 [
        "identificador" => "fig0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 901
            "Ancho" => 1675
            "Tamanyo" => 42822
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0025"
            "detalle" => "Figure "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Prescribed intake&#47;basal metabolic rate&#44; adherence&#47;prescribed intake and adherence&#47;basal metabolic rate ratios by phase of illness&#46;</p> <p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">A&#47;BMR&#44; adherence&#47;basal metabolic rate&#59; A&#47;P&#44; adherence&#47;prescribed intake&#59; P&#47;BMR&#44; prescribed intake&#47;basal metabolic rate&#46;</p> <p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">&#42;Wilcoxon test&#46;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0030"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">IQR&#44; interquartile range&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variable</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Male sex&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">79 &#40;60&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Age &#40;months&#41;&#44; median &#40;IQR&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;4&#8211;47&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Age&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>0&#8211;12 months&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">58 &#40;44&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>12&#8211;24 months&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19 &#40;14&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>2&#8211;5 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34 &#40;26&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>5&#8211;10 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;1&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>10&#8211;18 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18 &#40;13&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Reason for admission&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Infectious&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">53 &#40;40&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Postsurgical&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31 &#40;23&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Cardiovascular&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19 &#40;14&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Neurologic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;7&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Respiratory&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;5&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Other&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;6&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Blood or solid tumour&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;2&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Comorbidity&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">128 &#40;97&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Type of comorbidity</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Cardiovascular&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">49 &#40;38&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Other&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42 &#40;32&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Blood or solid tumour&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20 &#40;15&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Neurologic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;12&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Respiratory&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;0&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Phase of illness&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Acute&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;9&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Non-acute&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">118 &#40;90&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Nutritional status&#44;</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a><span class="elsevierStyleItalic">n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Undernutrition&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32 &#40;24&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Risk of undernutrition&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;8&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Adequate nutrition&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">48 &#40;36&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Overweight&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;12&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Obesity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;6&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Height&#44; n &#40;&#37;&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Short statute&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35 &#40;37&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Feeding modality&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Exclusive enteral nutrition&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">101 &#40;77&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Enteral &#43; parenteral nutrition&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;6&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Parenteral nutrition&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;4&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Nil per os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;4&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Parenteral &#43; oral nutrition&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;3&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Enteral &#43; oral nutrition&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;3&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Suspension of nutritional support&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">38 &#40;29&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Reason for suspension&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Invasive procedure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;34&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Other&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Non-invasive diagnostic procedure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;15&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Airway management&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;15&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Gastrointestinal dysfunction&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;10&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Mechanical problems in enteral delivery&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;2&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3485483.png"
              ]
            ]
          ]
          "notaPie" => array:2 [
            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">116&#47;131&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0010"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0010">94&#47;131&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Clinical&#44; demographic and nutritional characteristics of the patients&#46;</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0035"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">BMR&#44; basal metabolic rate&#59; IQR&#44; interquartile range&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Total sample&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Acute phase&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Non-acute phase&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span><a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;9&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">118 &#40;90&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Protein</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Prescribed&#47;required&#44; median &#40;IQR&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;09 &#40;0&#46;82&#8211;1&#46;55&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;66 &#40;0&#46;04&#8211;1&#46;09&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;15 &#40;0&#46;89&#8211;1&#46;57&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;0009&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Delivered&#47;required&#44; median &#40;IQR&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;01 &#40;0&#46;67&#8211;1&#46;43&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;3 &#40;0&#46;0&#8211;0&#46;58&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;06 &#40;0&#46;79&#8211;1&#46;48&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;0002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Delivered&#47;prescribed&#44; median &#40;IQR&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;0&#46;8&#8722;2&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;67 &#40;0&#8722;0&#46;96&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;0&#46;83&#8722;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Energy</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Prescribed&#47;BMR&#44; median &#40;IQR&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;27 &#40;0&#46;80&#8211;1&#46;81&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;47 &#40;0&#46;13&#8211;1&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;3 &#40;0&#46;87&#8211;1&#46;84&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;0054&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Delivered&#47;BMR&#44; median &#40;IQR&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;11 &#40;0&#46;69&#8211;1&#46;71&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;43 &#40;0&#8211;0&#46;55&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;17 &#40;0&#46;8&#8211;1&#46;73&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;0005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Delivered&#47;prescribed&#44; median &#40;IQR&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;0&#46;79&#8211;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;66 &#40;0&#8211;0&#46;93&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;0&#46;83&#8211;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3485484.png"
              ]
            ]
          ]
          "notaPie" => array:1 [
            0 => array:3 [
              "identificador" => "tblfn0015"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Comparison of acute phase vs&#46; non-acute phase&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Ratios of energy and protein intake requirements&#44; prescription and delivery &#40;adherence&#41; in the total sample and by phase of illness&#46;</p>"
        ]
      ]
      4 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0040"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">BMR&#44; basal metabolic rate&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td-with-role" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t ; entry_with_role_colgroup " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Acute &#40;n &#61; 13&#41;</th><th class="td-with-role" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t ; entry_with_role_colgroup " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Non-acute &#40;n &#61; 118&#41;</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col"><span class="elsevierStyleItalic">P</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#60;90&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">90&#37;&#8211;110&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#62;110&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#60;90&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">90&#37;&#8211;110&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#62;110&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prescribed&#47;BMR&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;69&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;30&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31 &#40;26&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15 &#40;12&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">72 &#40;61&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adherence&#47;BMR&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;77&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;23&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39 &#40;33&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;13&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">63 &#40;53&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;009&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adherence&#47;prescribed&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;69&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;23&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36 &#40;30&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">79 &#40;67&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;2&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3485481.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Energy requirements&#44; prescribed intake and adherence &#40;delivered amount&#41; to prescribed intake ratios by phase of illness&#46;</p>"
        ]
      ]
      5 => array:8 [
        "identificador" => "tbl0020"
        "etiqueta" => "Table 4"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0045"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">IQR&#44; interquartile range&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Variable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td-with-role" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t ; entry_with_role_colgroup " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Phase of illness</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col"><span class="elsevierStyleItalic">P</span><a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Acute&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Non-acute&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Prescribed protein &#40;g&#47;kg&#47;day&#41;&#44; median &#40;IQR&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;64 &#40;1&#46;21&#8211;2&#46;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;45 &#40;0&#46;1&#8211;1&#46;42&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;71 &#40;1&#46;33&#8211;2&#46;36&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;0009&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#60;1&#46;5 g&#47;kg&#47;day</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">57 &#40;43&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;17&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">47 &#40;82&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Median &#40;IQR&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;2 &#40;0&#46;5&#8722;1&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;24 &#40;0&#8722;0&#46;51&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;2 &#40;0&#46;74&#8722;1&#46;38&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleItalic">1&#46;5 g&#47;kg&#47;day</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">74 &#40;56&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;4&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">71 &#40;95&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Median &#40;IQR&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;2 &#40;1&#46;8&#8211;2&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;34 &#40;1&#46;63&#8211;3&#46;04&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;2 &#40;1&#46;79&#8211;2&#46;82&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;9891&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Delivered protein &#40;g&#47;kg&#47;day&#41;&#44; median &#40;IQR&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;51 &#40;1&#8211;2&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;34 &#40;0&#8211;0&#46;43&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;6 &#40;1&#46;2&#8211;2&#46;21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;0002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#60;1&#46;5 g&#47;kg&#47;day</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">63 &#40;48&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;17&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">52 &#40;82&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Median &#40;IQR&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;0&#46;3&#8211;1&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;16 &#40;0&#8211;0&#46;39&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;19 &#40;0&#46;49&#8211;1&#46;35&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleItalic">1&#46;5 g&#47;kg&#47;day</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">68 &#40;51&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;2&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">66 &#40;97&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Median &#40;IQR&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;9 &#40;1&#46;7&#8211;2&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;34 &#40;1&#46;32-2&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;92 &#40;1&#46;67&#8211;2&#46;78&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;9891&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3485482.png"
              ]
            ]
          ]
          "notaPie" => array:1 [
            0 => array:3 [
              "identificador" => "tblfn0020"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0020">Comparison of patients in acute and non-acute phases of illness&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Protein intake by phase of illness&#46;</p>"
        ]
      ]
      6 => array:5 [
        "identificador" => "upi0005"
        "tipo" => "MULTIMEDIAECOMPONENTE"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "Ecomponente" => array:2 [
          "fichero" => "mmc1.pdf"
          "ficheroTamanyo" => 191497
        ]
      ]
      7 => array:5 [
        "identificador" => "fig0015"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx1.jpeg"
            "Alto" => 750
            "Ancho" => 1333
            "Tamanyo" => 153542
          ]
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:37 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Causes and consequences of inadequate substrate supply to pediatric ICU patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46;M&#46; Hulst"
                            1 => "K&#46;F&#46; Joosten"
                            2 => "D&#46; Tibboel"
                            3 => "J&#46;B&#46; van Goudoever"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/01.mco.0000222115.91783.71"
                      "Revista" => array:6 [
                        "tituloSerie" => "Curr Opin Clin Nutr Metab Care"
                        "fecha" => "2006"
                        "volumen" => "9"
                        "paginaInicial" => "297"
                        "paginaFinal" => "303"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16607132"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nutritional support and the role of the stress response in critically ill children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "K&#46;F&#46; Joosten"
                            1 => "D&#46; Kerklaan"
                            2 => "S&#46;C&#46; Verbruggen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/MCO.0000000000000268"
                      "Revista" => array:6 [
                        "tituloSerie" => "Curr Opin Clin Nutr Metab Care"
                        "fecha" => "2016"
                        "volumen" => "19"
                        "paginaInicial" => "226"
                        "paginaFinal" => "233"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26963579"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nutritional support of the critically ill pediatric patient&#58; foundations and controversies"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "I&#46;J&#46; Ardila G&#243;mez"
                            1 => "C&#46;B&#46; Gonz&#225;lez"
                            2 => "P&#46;A&#46; Mart&#237;nez Palacio"
                            3 => "E&#46;T&#46; Mercado Santis"
                            4 => "J&#46;D&#46; Tibaduiza Bayona"
                            5 => "J&#46;P&#46; Contreras Hern&#225;ndez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1177/1179560317701108"
                      "Revista" => array:5 [
                        "tituloSerie" => "Clin Med Insights&#58; Trauma Intensive Med"
                        "fecha" => "2017"
                        "volumen" => "8"
                        "paginaInicial" => "1"
                        "paginaFinal" => "7"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Can energy intake alter clinical and hospital outcomes in PICU&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "B&#46;M&#46;K&#46; Larsen"
                            1 => "M&#46;R&#46; Beggs"
                            2 => "A&#46;Y&#46; Leong"
                            3 => "S&#46;H&#46; Kang"
                            4 => "R&#46; Persad"
                            5 => "G&#46; Garcia Guerra"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.clnesp.2018.02.002"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Nutr ESPEN"
                        "fecha" => "2018"
                        "volumen" => "24"
                        "paginaInicial" => "41"
                        "paginaFinal" => "46"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29576361"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Definitions&#44; predictors and outcomes of feeding intolerance in critically ill children&#58; a systematic review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "R&#46;D&#46; Eveleens"
                            1 => "K&#46;F&#46;M&#46; Joosten"
                            2 => "B&#46;A&#46;E&#46; de Koning"
                            3 => "J&#46;M&#46; Hulst"
                            4 => "S&#46;C&#46;A&#46;T&#46; Verbruggen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.clnu.2019.03.026"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Nutr"
                        "fecha" => "2020"
                        "volumen" => "39"
                        "paginaInicial" => "685"
                        "paginaFinal" => "693"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30962102"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Metabolic support in the critically ill&#58; a consensus of 19"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Wernerman"
                            1 => "K&#46;B&#46; Christopher"
                            2 => "D&#46; Annane"
                            3 => "M&#46;P&#46; Casaer"
                            4 => "C&#46;M&#46; Coopersmith"
                            5 => "A&#46;M&#46; Deane"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/s13054-019-2597-0"
                      "Revista" => array:4 [
                        "tituloSerie" => "Crit Care"
                        "fecha" => "2019"
                        "volumen" => "23"
                        "paginaInicial" => "318"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Basics in clinical nutrition&#58; metabolic response to injury and sepsis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "L&#46; Sobotka"
                            1 => "P&#46;B&#46; Soeters"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.eclnm.2008.07.005"
                      "Revista" => array:5 [
                        "tituloSerie" => "e-ESPEN"
                        "fecha" => "2009"
                        "volumen" => "4"
                        "paginaInicial" => "e1"
                        "paginaFinal" => "e3"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nutritional support for children during critical illness&#58; European Society of Pediatric and Neonatal Intensive Care &#40;ESPNIC&#41; metabolism&#44; endocrine and nutrition section position statement and clinical recommendations"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "L&#46;N&#46; Tume"
                            1 => "F&#46;V&#46; Valla"
                            2 => "K&#46; Joosten"
                            3 => "C&#46; Jotterand Chaparro"
                            4 => "L&#46; Latten"
                            5 => "L&#46;V&#46; Marino"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00134-019-05922-5"
                      "Revista" => array:6 [
                        "tituloSerie" => "Intensive Care Med"
                        "fecha" => "2020"
                        "volumen" => "46"
                        "paginaInicial" => "411"
                        "paginaFinal" => "425"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32077997"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Estimation of resting energy expenditure using predictive equations in critically ill children&#58; results of a systematic review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46; Jotterand Chaparro"
                            1 => "C&#46; Moullet"
                            2 => "P&#46; Taff&#233;"
                            3 => "J&#46; Laure Depeyre"
                            4 => "M&#46;H&#46; Perez"
                            5 => "D&#46; Longchamp"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/jpen.1146"
                      "Revista" => array:6 [
                        "tituloSerie" => "JPEN J Parenter Enteral Nutr"
                        "fecha" => "2018"
                        "volumen" => "42"
                        "paginaInicial" => "976"
                        "paginaFinal" => "986"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29603276"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Performance of predictive equations specifically developed to estimate resting energy expenditure in ventilated critically ill children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46; Jotterand Chaparro"
                            1 => "P&#46; Taff&#233;"
                            2 => "C&#46; Moullet"
                            3 => "J&#46; Laure Depeyre"
                            4 => "D&#46; Longchamp"
                            5 => "M&#46;H&#46; Perez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jpeds.2016.12.063"
                      "Revista" => array:3 [
                        "tituloSerie" => "J Pediatr"
                        "fecha" => "2017"
                        "volumen" => "184"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Predicting basal metabolic rate&#44; new standards and review of previous work"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "W&#46;N&#46; Schofield"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Hum Nutr Clin Nutr"
                        "fecha" => "1985"
                        "volumen" => "39"
                        "numero" => "Suppl 1"
                        "paginaInicial" => "5"
                        "paginaFinal" => "41"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4044297"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Guidelines for the provision and assessment of nutrition support therapy in the pediatric critically ill patient&#58; Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "N&#46;M&#46; Mehta"
                            1 => "H&#46;E&#46; Skillman"
                            2 => "S&#46;Y&#46; Irving"
                            3 => "J&#46;A&#46; Coss-Bu"
                            4 => "S&#46; Vermilyea"
                            5 => "E&#46;A&#46; Farrington"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1177/0148607117711387"
                      "Revista" => array:6 [
                        "tituloSerie" => "JPEN J Parenter Enteral Nutr"
                        "fecha" => "2017"
                        "volumen" => "41"
                        "paginaInicial" => "706"
                        "paginaFinal" => "742"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28686844"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Adequate enteral protein intake is inversely associated with 60-d mortality in critically ill children&#58; a multicenter&#44; prospective&#44; cohort study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "N&#46;M&#46; Mehta"
                            1 => "L&#46;J&#46; Bechard"
                            2 => "D&#46; Zurakowski"
                            3 => "C&#46;P&#46; Duggan"
                            4 => "D&#46;K&#46; Heyland"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3945/ajcn.114.104893"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Clin Nutr"
                        "fecha" => "2015"
                        "volumen" => "102"
                        "paginaInicial" => "199"
                        "paginaFinal" => "206"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25971721"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The metabolic response to stress and infection in critically ill children&#58; the opportunity of an individualized approach"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "V&#46; De Cosmi"
                            1 => "G&#46;P&#46; Milani"
                            2 => "A&#46; Mazzocchi"
                            3 => "V&#46; d&#8217;Oria"
                            4 => "M&#46; Silano"
                            5 => "E&#46; Calderini"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3390/nu9091032"
                      "Revista" => array:5 [
                        "tituloSerie" => "Nutrients"
                        "fecha" => "2017"
                        "volumen" => "9"
                        "paginaInicial" => "1032"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28926994"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Why patients in critical care do not receive adequate enteral nutrition&#63; A review of the literature"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "H&#46; Kim"
                            1 => "N&#46;A&#46; Stotts"
                            2 => "E&#46;S&#46; Froelicher"
                            3 => "M&#46;M&#46; Engler"
                            4 => "C&#46; Porter"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jcrc.2012.07.019"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Crit Care"
                        "fecha" => "2012"
                        "volumen" => "27"
                        "paginaInicial" => "702"
                        "paginaFinal" => "713"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23084129"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nutritional practices and their relationship to clinical outcomes in critically ill children&#8212;an international multicenter cohort study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "N&#46;M&#46; Mehta"
                            1 => "L&#46;J&#46; Bechard"
                            2 => "N&#46; Cahill"
                            3 => "M&#46; Wang"
                            4 => "A&#46; Day"
                            5 => "C&#46;P&#46; Duggan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/CCM.0b013e31824e18a8"
                      "Revista" => array:6 [
                        "tituloSerie" => "Crit Care Med"
                        "fecha" => "2012"
                        "volumen" => "40"
                        "paginaInicial" => "2204"
                        "paginaFinal" => "2211"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22564954"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A prospective survey of nutritional support practices in intensive care unit patients&#58; what is prescribed&#63; What is delivered&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "B&#46; De Jonghe"
                            1 => "C&#46; Appere-De-Vechi"
                            2 => "M&#46; Fournier"
                            3 => "B&#46; Tran"
                            4 => "J&#46; Merrer"
                            5 => "J&#46;C&#46; Melchior"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/00003246-200101000-00002"
                      "Revista" => array:6 [
                        "tituloSerie" => "Crit Care Med"
                        "fecha" => "2001"
                        "volumen" => "29"
                        "paginaInicial" => "8"
                        "paginaFinal" => "12"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11176150"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Challenges to optimal enteral nutrition in a multidisciplinary pediatric intensive care unit"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "N&#46;M&#46; Mehta"
                            1 => "D&#46; McAleer"
                            2 => "S&#46; Hamilton"
                            3 => "E&#46; Naples"
                            4 => "K&#46; Leavitt"
                            5 => "P&#46; Mitchell"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1177/0148607109348065"
                      "Revista" => array:5 [
                        "tituloSerie" => "JPEN J Parenter Enteral Nutr"
                        "fecha" => "2010"
                        "volumen" => "34"
                        "paginaInicial" => "38"
                        "paginaFinal" => "45"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "What are the factors that influence the attainment of satisfactory energy intake in pediatric intensive care unit patients receiving enteral or parenteral nutrition&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "F&#46;S&#46; De Menezes"
                            1 => "H&#46;P&#46; Leite"
                            2 => "P&#46;C&#46; Nogueira"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.nut.2012.04.003"
                      "Revista" => array:6 [
                        "tituloSerie" => "Nutrition"
                        "fecha" => "2013"
                        "volumen" => "29"
                        "paginaInicial" => "76"
                        "paginaFinal" => "80"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22898265"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Barriers to adequate nutrition in critically ill children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "E&#46;J&#46; Rogers"
                            1 => "H&#46;R&#46; Gilbertson"
                            2 => "R&#46;G&#46; Heine"
                            3 => "R&#46; Henning"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/s0899-9007(03)00170-9"
                      "Revista" => array:6 [
                        "tituloSerie" => "Nutrition"
                        "fecha" => "2003"
                        "volumen" => "19"
                        "paginaInicial" => "865"
                        "paginaFinal" => "868"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14559322"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nutrition support in critically ill children&#58; underdelivery of energy and protein compared with current recommendations"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "U&#46;G&#46; Kyle"
                            1 => "N&#46; Jaimon"
                            2 => "J&#46;A&#46; Coss-Bu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jand.2012.07.038"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Acad Nutr Diet"
                        "fecha" => "2012"
                        "volumen" => "112"
                        "paginaInicial" => "1987"
                        "paginaFinal" => "1992"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23063414"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nutritional survey in critically ill children&#58; a single center study in China"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Li"
                            1 => "B&#46; Li"
                            2 => "J&#46; Qian"
                            3 => "J&#46; Zhang"
                            4 => "H&#46; Ren"
                            5 => "B&#46; Ning"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.21037/tp-19-173"
                      "Revista" => array:6 [
                        "tituloSerie" => "Transl Pediatr"
                        "fecha" => "2020"
                        "volumen" => "9"
                        "paginaInicial" => "221"
                        "paginaFinal" => "230"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32775240"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nutritional goals&#44; prescription and delivery in a pediatric intensive care unit"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46; De Neef"
                            1 => "V&#46;G&#46; Geukers"
                            2 => "A&#46; Dral"
                            3 => "R&#46; Lindeboom"
                            4 => "H&#46;P&#46; Sauerwein"
                            5 => "A&#46;P&#46; Bos"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.clnu.2007.10.013"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Nutr"
                        "fecha" => "2008"
                        "volumen" => "27"
                        "paginaInicial" => "65"
                        "paginaFinal" => "71"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18068875"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Implementation of nutrition support guidelines may affect energy and protein intake in the pediatric intensive care unit"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "U&#46;G&#46; Kyle"
                            1 => "L&#46;A&#46; Lucas"
                            2 => "G&#46; Mackey"
                            3 => "J&#46;C&#46; Silva"
                            4 => "J&#46; Lusk"
                            5 => "R&#46; Orellana"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jand.2016.01.005"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Acad Nutr Diet"
                        "fecha" => "2016"
                        "volumen" => "116"
                        "paginaInicial" => "844"
                        "paginaFinal" => "851"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27126156"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Patrones de crecimiento de lactantes&#44; ni&#241;os y ni&#241;as menores de 5 a&#241;os &#40;OMS 2006&#41; &#91;Accessed 22 April 2022&#93;&#46; Available from&#58; <a target="_blank" href="http://www.who.int/childgrowth/standards/es/">http&#58;&#47;&#47;www&#46;who&#46;int&#47;childgrowth&#47;standards&#47;es&#47;</a>&#46;"
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Patrones de crecimiento de escolares y adolescentes entre 5 a&#241;os 1 mes y 19 a&#241;os &#40;OMS 2007&#41; &#91;Accessed 22 April 2022&#93;&#46; Available from&#58; <a target="_blank" href="http://www.who.int/growthref/en/">http&#58;&#47;&#47;www&#46;who&#46;int&#47;growthref&#47;en&#47;</a>&#46;"
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Patrones de crecimiento para la evaluaci&#243;n nutricional de ni&#241;os&#44; ni&#241;as y adolescentes desde el nacimiento hasta los 19 a&#241;os de edad&#44;Ministerio de Salud&#44; 2018 &#91;Accessed 22 April 2022&#93;&#46; Available from&#58; <a target="_blank" href="http://www.bibliotecaminsal.cl/wp/wp-content/uploads/2018/07/2018.06.14-PAC_Interior-con-lineas-de-corte-14-juliov3.pdf">http&#58;&#47;&#47;www&#46;bibliotecaminsal&#46;cl&#47;wp&#47;wp-content&#47;uploads&#47;2018&#47;07&#47;2018&#46;06&#46;14-PAC&#95;Interior-con-lineas-de-corte-14-juliov3&#46;pdf</a>&#46;"
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Growth charts for children with down syndrome in the United States"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "B&#46;S&#46; Zemel"
                            1 => "M&#46; Pipan"
                            2 => "V&#46;A&#46; Stallings"
                            3 => "W&#46; Hall"
                            4 => "K&#46; Schadt"
                            5 => "D&#46;S&#46; Freedman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1542/peds.2015-1652"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatrics"
                        "fecha" => "2015"
                        "volumen" => "136"
                        "paginaInicial" => "e1204"
                        "paginaFinal" => "e1211"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26504127"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Low weight&#44; morbidity&#44; and mortality in children with cerebral palsy&#58; new clinical growth charts"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46; Brooks"
                            1 => "S&#46; Day"
                            2 => "R&#46; Shavelle"
                            3 => "D&#46; Strauss"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1542/peds.2010-2801"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatrics"
                        "fecha" => "2011"
                        "volumen" => "128"
                        "paginaInicial" => "e299"
                        "paginaFinal" => "e307"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21768315"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Barriers to adequate nutrition in critically ill children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "E&#46;J&#46; Rogers"
                            1 => "H&#46;R&#46; Gilbertson"
                            2 => "R&#46;G&#46; Heine"
                            3 => "R&#46; Henning"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/s0899-9007(03)00170-9"
                      "Revista" => array:6 [
                        "tituloSerie" => "Nutrition"
                        "fecha" => "2003"
                        "volumen" => "19"
                        "paginaInicial" => "865"
                        "paginaFinal" => "868"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14559322"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The effect of cumulative energy and protein deficiency on anthropometric parameters in a pediatric ICU population"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;M&#46; Hulst"
                            1 => "J&#46;B&#46; van Goudoever"
                            2 => "L&#46;J&#46; Zimmermann"
                            3 => "W&#46;C&#46; Hop"
                            4 => "M&#46;J&#46; Albers"
                            5 => "D&#46; Tibboel"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.clnu.2004.05.006"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Nutr"
                        "fecha" => "2004"
                        "volumen" => "23"
                        "paginaInicial" => "1381"
                        "paginaFinal" => "1389"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15556260"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "32"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Energy imbalance and the risk of overfeeding in critically ill children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "N&#46;M&#46; Mehta"
                            1 => "L&#46;J&#46; Bechard"
                            2 => "M&#46; Dolan"
                            3 => "K&#46; Ariagno"
                            4 => "H&#46; Jiang"
                            5 => "C&#46; Duggan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/PCC.0b013e3181fe279c"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Crit Care Med"
                        "fecha" => "2011"
                        "volumen" => "12"
                        "paginaInicial" => "398"
                        "paginaFinal" => "405"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20975614"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib0165"
              "etiqueta" => "33"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Energy expenditure and balance following pediatric intensive care unit admission&#58; a longitudinal study of critically ill children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46;J&#46; Oosterveld"
                            1 => "M&#46; van der Kuip"
                            2 => "K&#46; de Meer"
                            3 => "H&#46;J&#46; de Greef"
                            4 => "R&#46;J&#46; Gemke"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/01.PCC.0000194011.18898.90"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Crit Care Med"
                        "fecha" => "2006"
                        "volumen" => "7"
                        "paginaInicial" => "147"
                        "paginaFinal" => "153"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16531947"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib0170"
              "etiqueta" => "34"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Enteral tube feeding in the intensive care unit&#58; factors impeding adequate delivery"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46;A&#46; McClave"
                            1 => "L&#46;K&#46; Sexton"
                            2 => "D&#46;A&#46; Spain"
                            3 => "J&#46;L&#46; Adams"
                            4 => "N&#46;A&#46; Owens"
                            5 => "M&#46;B&#46; Sullins"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/00003246-199907000-00003"
                      "Revista" => array:6 [
                        "tituloSerie" => "Crit Care Med"
                        "fecha" => "1999"
                        "volumen" => "27"
                        "paginaInicial" => "1252"
                        "paginaFinal" => "1256"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10446815"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            34 => array:3 [
              "identificador" => "bib0175"
              "etiqueta" => "35"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "American Society for Parenteral and Enteral Nutrition Board of Directors&#44; Clinical guidelines for the use of parenteral and enteral nutrition in adult and pediatric patients&#58; applying the GRADE system to development of A&#46;S&#46;P&#46;E&#46;N&#46; clinical guidelines"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;E&#46; Druyan"
                            1 => "C&#46; Compher"
                            2 => "J&#46;I&#46; Boullata"
                            3 => "C&#46;L&#46; Braunschweig"
                            4 => "D&#46;E&#46; George"
                            5 => "E&#46; Simpser"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1177/0148607111420157"
                      "Revista" => array:6 [
                        "tituloSerie" => "JPEN J Parenter Enteral Nutr"
                        "fecha" => "2012"
                        "volumen" => "36"
                        "paginaInicial" => "77"
                        "paginaFinal" => "80"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22179521"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            35 => array:3 [
              "identificador" => "bib0180"
              "etiqueta" => "36"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nutrition delivery affects outcomes in pediatric acute respiratory distress syndrome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46;J&#46; Wong"
                            1 => "W&#46;M&#46; Han"
                            2 => "R&#46; Sultana"
                            3 => "T&#46;F&#46; Loh"
                            4 => "J&#46;H&#46; Lee"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1177/0148607116637937"
                      "Revista" => array:6 [
                        "tituloSerie" => "JPEN J Parenter Enteral Nutr"
                        "fecha" => "2017"
                        "volumen" => "41"
                        "paginaInicial" => "1007"
                        "paginaFinal" => "1113"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26962064"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            36 => array:3 [
              "identificador" => "bib0185"
              "etiqueta" => "37"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "How much protein and energy are needed to equilibrate nitrogen and energy balances in ventilated critically ill children&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "C&#46; Jotterand Chaparro"
                            1 => "J&#46; Laure Depeyre"
                            2 => "D&#46; Longchamp"
                            3 => "M&#46;H&#46; Perez"
                            4 => "P&#46; Taff&#233;"
                            5 => "J&#46; Cotting"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.clnu.2015.03.015"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Nutr"
                        "fecha" => "2016"
                        "volumen" => "35"
                        "paginaInicial" => "460"
                        "paginaFinal" => "467"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25912187"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/23412879/0000009900000002/v2_202403140552/S2341287923001643/v2_202403140552/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "26005"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Original Articles"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/23412879/0000009900000002/v2_202403140552/S2341287923001643/v2_202403140552/en/main.pdf?idApp=UINPBA00005H&text.app=https://analesdepediatria.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287923001643?idApp=UINPBA00005H"
]

Article information

ISSN: 23412879
Original language: English

DOI:10.1016/j.anpede.2023.07.005

The statistics are updated each day

Year/Month	Html	Pdf	Total

2024 October	92	39	131
2024 September	76	41	117
2024 August	84	62	146
2024 July	93	39	132
2024 June	70	39	109
2024 May	114	35	149
2024 April	99	47	146
2024 March	79	29	108
2024 February	140	58	198
2024 January	151	32	183
2023 December	160	31	191
2023 November	177	54	231
2023 October	171	43	214
2023 September	147	52	199
2023 August	308	61	369

Show all

Indexed in:

Follow us:

Subscribe:

Statistics

Indexed in:

Follow us:

Subscribe:

Statistics

Subscribe to our newsletter