Clinical and Experimental Pediatrics最新文献

{"title":"Neonatal ichthyosis-sclerosing cholangitis syndrome caused by a novel CLDN1 mutation: a case report and literature review.","authors":"Upasana Ghosh, Ankit Agrawal, Varunvenkat M Srinivasan, Rani Manisha, Umesh Shukla, Vikas Jain, Mayank Nilay, Harish Kumar","doi":"10.3345/cep.2025.00906","DOIUrl":"https://doi.org/10.3345/cep.2025.00906","url":null,"abstract":"<p><p>Neonatal ichthyosis-sclerosing cholangitis syndrome (NISCH) is an autosomal recessive disorder characterized by cholestasis, generalized ichthyosis, alopecia, and dental anomalies. As this is a rare syndrome, here we present a case caused by a novel mutation followed by a literature review of all published cases. This retrospective review includes all original articles on the clinical profiles of all 37 cases published through December 2024 using a PubMed search. The patient was a 2-month-old boy who presented with cholestasis, sparse hair, and generalized ichthyosis. Whole-exome sequencing revealed a novel pathogenic variation in exon 1 of the CLDN1 gene: (NM_021101.5) c.36dupT (p.Leu13SerfsTer56). The patient was symptomatically managed, and his condition improved. Among the 37 reported cases, the median age at diagnosis was 60 months (range, 1-636 months). Patients of Moroccan ethnicity were most commonly affected, and c.200_201delTT was the most common mutation. Among the clinical features, ichthyosis was universal (37 of 37 [100%]), followed by jaundice in 70.2% (26 of 37), pruritus in 38.2% (13 of 34), hepatomegaly in 43.3% (13 of 30), and splenomegaly in 23.8% (5 of 21) of patients. Portal hypertension (7 of 35 [20%]) and mental retardation (3 of 21 [14.2%]) were rare. The disease phenotype varied from no liver involvement or transient neonatal cholestasis to end-stage liver disease. Progressive liver disease was reported in 8 patients, five of whom underwent liver transplantation. NISCH is a rare syndrome with variable phenotypes ranging from no liver involvement and transient neonatal cholestasis to advanced liver disease requiring liver transplantation. Therefore, a multidisciplinary approach with close follow-up is required.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuous glucose monitoring in Korean pediatric patients with type 1 diabetes: current landscape and clinical implications.","authors":"Hwa Young Kim, Jaehyun Kim","doi":"10.3345/cep.2025.01522","DOIUrl":"https://doi.org/10.3345/cep.2025.01522","url":null,"abstract":"<p><p>Continuous glucose monitoring (CGM) has become a key component in the management of pediatric type 1 diabetes mellitus (T1DM) since it offers real-time glucose data that facilitate tighter glycemic control and reduce acute complications. Accumulating evidence and international guidelines highlight the clinical efficacy, safety, and feasibility of CGM use in children, particularly those with high adherence. Regular CGM use is associated with significant reductions in glycated hemoglobin, fewer hypo- and hyperglycemia episodes, and improved quality of life for both patients and their caregivers. Recent advances in CGM technology-including improved accuracy, extended sensor wear, factory calibration, and customizable alerts-have enhanced their usability in pediatric populations. In addition to established CGM metrics such as time in range, time below range, and glycemic variability, a novel parameter-time in tight range (also referred as time in normoglycemia), defined as the percentage of time with blood glucose readings within 70-140 mg/dL-has emerged as a potentially more sensitive marker of optimal glycemic control in children. This review provides a comprehensive overview of CGM technologies, including device types, performance metrics, and clinical evidence supporting their use for pediatric T1DM. It also examines recent advancements in Korea such as expanded insurance reimbursement and clinical integration. As CGM becomes more accessible and technologically advanced, it is expected to play an increasingly central role in optimizing long-term outcomes for children and adolescents with T1DM.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes and healthcare utilization of hospitalized children with influenza versus COVID-19.","authors":"David Chun-Ern Ng, Chuin-Hen Liew, Kah Kee Tan, Joanne Pereira, Muhammad Ihsan Roslan, Xiang Lin Cheng, Hui Yi Lim, Farah Nuruliayana A Nazri, Asuwani Maran, Wan Fei Wong, Yasothai Chandran, Syaniza Shaharudin, Pon Ling Lau, Naveen Nair Gangadaran, Marlindawati Mohd Ali","doi":"10.3345/cep.2025.00759","DOIUrl":"https://doi.org/10.3345/cep.2025.00759","url":null,"abstract":"<p><strong>Background: </strong>Influenza and coronavirus disease 2019 (COVID-19) are major causes of pediatric respiratory illness with overlapping clinical features but potentially differing impacts on healthcare utilization and outcomes.</p><p><strong>Purpose: </strong>To compare the clinical presentations, healthcare resource utilization, and outcomes of children hospitalized with influenza and COVID-19 and address the gaps in pediatric data from Southeast Asia.</p><p><strong>Methods: </strong>This retrospective observational study included children aged ≤12 years hospitalized with laboratoryconfirmed influenza or COVID-19 at a tertiary hospital in Malaysia between May 1, 2022, and May 1, 2023. Patients with viral or bacterial coinfections were excluded. Influenza A and B cases were collectively analyzed. The patients' demographic data, clinical presentation, resource utilization, and outcomes were also evaluated. Propensity score matching (PSM) was performed to balance the cohorts for age, sex, ethnicity, and comorbidities. Outcomes were compared using standardized mean differences (SMDs).</p><p><strong>Results: </strong>A total of 299 patients were included (influenza, n=177; COVID-19, n=122). Patients with influenza were older (median, 3.6 years vs. 1.8 years; P<0.001) and more likely to have fever, cough, and rhinorrhea. COVID-19 patients presented earlier in the illness (median, 2 days vs. 4 days; P<0.001). After PSM, 102 patients were included in each group. Patients with influenza required greater healthcare resource use, including intravenous fluids (60.8% vs. 43.1%; SMD=0.36), empirical antibiotics (40.2% vs. 12.7%; SMD=0.66), respiratory support (40.2% vs. 26.5%, SMD= 0.29), pediatric intensive care unit admission (10.8% vs. 2.9%; SMD=0.32), and longer duration of oxygen therapy (SMD=0.93).</p><p><strong>Conclusion: </strong>Children hospitalized for influenza demonstrated higher clinical severity and greater healthcare resource utilization than those hospitalized for COVID-19. These findings highlight the burden of influenza and inform hospital resource planning during periods of viral circulation.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging the gap: autism spectrum disorder in children in the United States and worldwide: a narrative review.","authors":"Sandhya J Kadam, Malika Goel","doi":"10.3345/cep.2025.00969","DOIUrl":"https://doi.org/10.3345/cep.2025.00969","url":null,"abstract":"<p><p>Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by difficulty with communication and social interactions as well as restricted or repetitive behaviors. Over the last few decades, the prevalence of ASD has increased globally, with major differences in reporting, diagnosis, and interventions between developed and developing countries. The United States (U.S.) has seen a sharp rise in diagnosed ASD cases, with a current prevalence of approximately 1 in 31 children, due to improved awareness, early screening programs, and timely intervention. The U.S. healthcare system supports early intervention services through policies such as the Individuals with Disabilities Education Act and insurance mandates for ASD coverage. However, countries in Latin America, Africa, and Asia face challenges in ASD care, including limited access, stigma, underdiagnosis, and lack of resources. The World Health Organization Caregiver Skills Training, a global initiative, and the involvement of nongovernmental organizations are gradually bridging this gap. An interprofessional approach highlighting cross-cultural research, training providers, screening tools, referral options, policy implementation, and community- based care on a global scale will help reduce disparities in ASD care among countries. Making ASD care a global public health priority could help ensure developmental and mental healthcare equity. This study compares ASD care in the U.S. to that worldwide, highlighting the importance of global collaboration for early detection, service availability, and research.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HLA‒B*58:01 and skin reactions in pediatric hematology and oncology patients treated with allopurinol.","authors":"Parisa Maneechai, Cholada Ratanatharathron, Jassada Buaboonnam, Kleebsabai Sanpakit","doi":"10.3345/cep.2025.01032","DOIUrl":"https://doi.org/10.3345/cep.2025.01032","url":null,"abstract":"<p><strong>Background: </strong>Allopurinol is widely used to prevent hyperuricemia in patients with tumor lysis syndrome. However, its use can trigger severe cutaneous adverse reactions (SCARs) with a mortality rate of approximately 11.39%. The human leukocyte antigen (HLA)-B*58:01 genotype is a major risk factor for SCARs. Although most studies to date have examined HLA-B*58:01 in Thai adults, data on pediatric patients are limited.</p><p><strong>Purpose: </strong>Here we aimed to evaluate the association between HLA-B*58:01 and skin reactions in children with hematological or oncological diagnoses receiving allopurinol and determine its prevalence in this population.</p><p><strong>Methods: </strong>Pediatric patients (age≤18 years) with hematological or oncological diseases who received allopurinol were enrolled in this cross-sectional study of previously exposed and newly prescribed cases. HLA-B*58:01 genotyping was performed to assess its association with skin reactions.</p><p><strong>Results: </strong>A total of 108 patients (mean age, 9.3 years) were included. Most patients (n=93, 86.1%) received allopurinol as prophylaxis for tumor lysis syndrome. Of them, 75 (69.4%) received allopurinol concomitantly with chemotherapy for malignancies, whereas the remaining patients received allopurinol during conditioning for hematopoietic stem cell transplantation. The prevalence of HLA-B*58:01 positivity was 17.6% (n=19 of 108 patients). The median exposure duration was 5 days (range, 1-19 days). No HLA-B*58:01-positive patients experienced a skin reaction. However, one patient who tested negative for HLA-B*58:01 developed a maculopapular rash on day 2 of the allopurinol therapy and required intravenous antihistamines.</p><p><strong>Conclusion: </strong>Short-duration allopurinol exposure likely mitigates the risk of SCARs regardless of HLA-B*58:01 status. Routine HLA-B*58:01 testing may not be warranted in pediatric patients receiving brief allopurinol courses. However, larger studies are required to confirm these findings.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of goal attainment for helmet therapy versus conservative management for positional plagiocephaly in infants.","authors":"Bjoern Vogt, Ariane Deutschle, Gerog Gosheger, Adrien Frommer, Andrea Laufer, Henning Tretow, Robert Roedl, Gregor Toporowski","doi":"10.3345/cep.2025.01102","DOIUrl":"https://doi.org/10.3345/cep.2025.01102","url":null,"abstract":"<p><strong>Background: </strong>Positional plagiocephaly (PP) is a common cranial asymmetry of infancy. Its treatment options include conservative management and helmet therapy. However, the efficacy of each, particularly at achieving a normal cranial shape, remains uncertain.</p><p><strong>Purpose: </strong>This study aimed to compare the efficacy of conservative management and helmet therapy for PP.</p><p><strong>Methods: </strong>We retrospectively analyzed 199 infants with PP treated in 2015-2024. A total of 72 patients with a minimum treatment duration of 90 days and minimum plagiocephaly severity level of 2 (Children's Healthcare Atlanta Plagiocephaly Severity Scale) were included. Of them, 36 received conservative management and 36 received helmet therapy. Each infant underwent three-dimensional surface scanning of the cranium (StarScanner).</p><p><strong>Results: </strong>The mean±standard deviation age at treatment initiation was 31.9±6.6 weeks in the helmet group versus 21.0±5.7 weeks in the conservative management group (P<0.001). The average treatment duration was 21.9 (interquartile range [IQR], 15.3-31.4) weeks vs. 20.6 (IQR, 14.1-26.6) weeks (P=0.171), respectively. The monthly correction speed of the cranial vault asymmetry index (CVAI) was comparable between groups (0.66±2.09 vs. 0.64±0.55, P=0.964). Plagiocephaly degree was reduced to level 1 in 9 of 36 patients (25%) who received helmet therapy versus 4 of 36 patients (11%) in the conservative management group (P=0.220), whereas a reduction in severity level was observed in 24 of 36 (67%) versus 15 of 36 (42%), respectively (P=0.058). In the helmet group, an earlier treatment initiation was significantly associated with a greater severity level reduction (r=-0.480, P=0.003). A longer treatment duration showed a trend toward a greater reduction in CVAI (r=0.331, P=0.052). In the conservative management group, both earlier treatment initiation (r=-0.537, P<0.001) and longer treatment duration (r=0.381, P=0.022) correlated significantly with improved outcomes.</p><p><strong>Conclusion: </strong>Conservative management and helmet therapy reduced cranial asymmetry with no significant difference in correction speed. An early treatment initiation was the strongest predictor of improvement, while a longer treatment duration was associated with better outcomes. A trend toward a greater reduction in severity level was observed with helmet therapy, suggesting its potential benefits in more severe cases.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ciclesonide shows a lung-protective effect in neonatal hyperoxia-exposed rats.","authors":"Victoria Mielgo, Miguel A Gomez-Solaetxe, Lara Olazar, Begoña Loureiro, Carmen Rey-Santano","doi":"10.3345/cep.2025.01137","DOIUrl":"https://doi.org/10.3345/cep.2025.01137","url":null,"abstract":"<p><strong>Background: </strong>Bronchopulmonary dysplasia (BPD), a chronic lung disease primarily observed in premature infants, is attributed to a lung injury-repair imbalance. Studies of postnatal corticosteroids have failed to identify clear candidates to help alleviate high BPD rates without risks or adverse effects.</p><p><strong>Purpose: </strong>This study aimed to assess whether the systemic postnatal administration of an alternative glucocorticoid, ciclesonide, could attenuate alterations in lung structure and right ventricular hypertrophy in a hyperoxic rat BPD-like model.</p><p><strong>Methods: </strong>In a hyperoxia-induced model of BPD-like lung injury, pups were maintained in oxygen-enriched atmosphere-hyperoxia or normoxia (room air) for 14 days after natural birth, and subcutaneous ciclesonide (0.5 mg/kg) was administered postnatally for 5 consecutive days. On postnatal day 14, lung function (peak inspiratory pressure and compliance), lung structure (radial alveolar count, mean linear intercept, and pulmonary vessel density), and right ventricular hypertrophy were assessed.</p><p><strong>Results: </strong>On day 14, the effects of hyperoxia exposure were more evident in untreated rats (impaired lung compliance and structure and right ventricular hypertrophy) than in normoxia-exposed animals. Ciclesonide administration was associated with smaller body weight changes and significantly improved lung compliance, alveolarization, lung vascular growth, and right ventricular hypertrophy.</p><p><strong>Conclusion: </strong>Postnatal ciclesonide administration preserved lung function and structure and prevented right ventricular hypertrophy in a hyperoxic BPD-like model. These findings suggest that postnatal ciclesonide may be an alternative to existing corticosteroids for the treatment of BPD. However, long-term studies are required to validate these findings.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Less invasive surfactant administration versus intubation-surfactant-extubation: a single-center retrospective study","authors":"Jithin Cs, Nalina A, Shashidhar A, Suman Rao Pn","doi":"10.3345/cep.2025.00332","DOIUrl":"10.3345/cep.2025.00332","url":null,"abstract":"<p><strong>Background: </strong>In recent years, minimally invasive methods have been increasingly utilized for surfactant administration in spontaneously breathing preterm infants with respiratory distress syndrome (RDS) managed with nasal continuous positive airway pressure owing to their feasibility and association with improved respiratory outcomes. However, data are limited from developing countries on the use and effectiveness of these techniques.</p><p><strong>Purpose: </strong>The primary objective of this study was to evaluate the effect of less invasive surfactant administration (LISA) and intubation-surfactant-extubation (InSurE) techniques on the need for intubation and invasive mechanical ventilation (MV) within 72 hours of surfactant administration in preterm neonates with RDS. The secondary objectives were the effects of these methods on the need for a second surfactant dose, mortality rate, and other preterm morbidities.</p><p><strong>Methods: </strong>This retrospective observational study was conducted in Southern India over 5 years. Clinical outcomes were analyzed in neonates with RDS at 24–34 weeks' gestation who received surfactants via the LISA or InSurE method.</p><p><strong>Results: </strong>A total of 98 neonates were divided into the LISA group (n=54) and the InSurE group (n=44). The need for intubation and MV within 72 hours was significantly lower in the LISA versus InSurE group (18% vs. 64%, P=0.04; relative risk, 0.28; 95% confidence interval, 0.16–0.53). The duration of invasive ventilation was significantly shorter in the LISA group (P<0.001). We observed no significant intergroup differences in the need for a second surfactant dose (17% vs. 7%, P=0.14), bronchopulmonary dysplasia (3.7% vs. 8.8%, P=0.49), or mortality (14.5% vs. 13%, P=0.47).</p><p><strong>Conclusion: </strong>LISA appears to be a less invasive and more effective alternative to InSurE, demonstrating the ability to reduce the need for intubation and invasive ventilation within the first 72 hours as well as the duration of invasive support in preterm infants with RDS.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recommendation for use of a long-acting monoclonal antibody to prevent respiratory syncytial virus infection in infants and young children.","authors":"Soo-Han Choi, Dong Hyun Kim, Jong Gyun Ahn, Ki Wook Yun, Byung-Wook Eun, Jin Lee, Jina Lee, Taek-Jin Lee, Hyunju Lee, Dae Sun Jo, Eun Young Cho, Hye-Kyung Cho, Young June Choe, Ui Yoon Choi, Yun-Kyung Kim","doi":"10.3345/cep.2025.01067","DOIUrl":"10.3345/cep.2025.01067","url":null,"abstract":"<p><p>Respiratory syncytial virus (RSV) is a leading cause of acute lower respiratory tract infections (LRTIs) in infants and young children. In April 2024, the Korea Ministry of Food and Drug Safety approved nirsevimab (Beyfortus), a long-acting monoclonal antibody, as a passive immunization to prevent RSV-associated LRTI among infants and young children. Nirsevimab was launched in Korea in February 2025. This report summarizes the recommendations of the Committee on Infectious Diseases of the Korean Pediatric Society regarding the use of nirsevimab. We recommend a single dose of nirsevimab for all neonates born during the RSV season (October to March), as well as all infants younger than 6 months at the start of the RSV season (i.e., those born between April and September of that year). Nirsevimab should be administered shortly after birth (within the first week of life) to neonates born during the RSV season and just before or early in the season (late September to October) to infants entering their first RSV season. Nirsevimab may also be considered for children younger than 2 years of age who are at increased risk of severe RSV disease and entering their second RSV season.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"742-750"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12488281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of postoperative enteral protein supplementation on nitrogen balance in critically ill children.","authors":"Irene Yuniar, Kadek Apik Lestari, Antonius Hocky Pudjiadi, Fatima Safira Alatas, Yoga Devaera","doi":"10.3345/cep.2025.00227","DOIUrl":"10.3345/cep.2025.00227","url":null,"abstract":"<p><strong>Background: </strong>Critically ill children are at risk of postoperative malnutrition. Thus, optimal nutritional therapy is essential for preventing morbidity development and reducing mortality rates among this population. An adequate protein intake increases anabolism. However, data on the effect of enteral protein supplementation on nitrogen balance (NB) and intestinal fatty acid-binding protein (I-FABP) levels in postoperative critically ill children remain limited.</p><p><strong>Purpose: </strong>This study aimed to analyze whether an increased protein intake via enteral nutrition improves NB and reduces serum I-FABP levels among postoperative critically ill children.</p><p><strong>Methods: </strong>This double-blind randomized controlled trial examined critically ill children aged 1-5 years who received early postoperative enteral nutrition. A total of 76 subjects were randomized into a standard-protein group (3.0 g/100 mL) or a high-protein group (4.35 g/100 mL). NB was assessed on days 1 and 3, while I-FABP levels were measured before and after 72 h of enteral feeding.</p><p><strong>Results: </strong>The high-protein group showed a significantly greater increase in average NB (283.4 [standard deviation, 82.5] mg/kg/day) compared to the standard-protein group (114.7 [standard deviation, 53] mg/kg/day) (P<0.0001). However, no significant decrease in I-FABP levels was noted in either group despite the above- and below-average NB improvements.</p><p><strong>Conclusion: </strong>High-protein enteral supplementation improves NB in postoperative critically ill children without causing adverse side effects.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"790-800"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12488283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}