P259 - DEVELOPING A DECISION TOOL TO DETERMINE WHICH PARENTERAL NUTRITION (PN) MIXTURE A PEDIATRIC PATIENT CAN SAFELY RECEIVE ACCORDING TO THE LATEST GUIDELINES.

P259

DEVELOPING A DECISION TOOL TO DETERMINE WHICH PARENTERAL NUTRITION (PN) MIXTURE A PEDIATRIC PATIENT CAN SAFELY RECEIVE ACCORDING TO THE LATEST GUIDELINES.

V. Tournoij^1,*, K. Dams^2,3

¹Clinical nutrition, ²Intensive Care Department, Antwerp University Hospital, Edegem, ³Laboratory of Experimental Medicine and Paediatrics (LEMP), Faculty of Medicine and Health Sciences, Antwerp, Belgium

Rationale: The pediatric population has its own specific characteristics and needs. PN prescription should be adapted according to the individual patients’ nutritional needs. This is a labor intensive job since a lot of variables have to be taken into account (age, weight, disease, …). We developed a tool that automatically applies all variables.

Methods: We collected the latest pediatric guidelines (ESPEN/ESPGHAN) and developed a page where you can decide to use the WHO or Schofield calculation formula. In addition a Physical Activity Level (PAL) factor, disease/stress factor, growth factor and energy absorption coefficient are applied and a formula calculates the caloric needs.

The following page shows an oversight of all the reference values according to age and weight (from 0 to 17 years and from 2,5 kg to 40 kg). We decide whether the  pediatric patient needs lipids, reduced lipids or no lipids and whether an electrolyte free (EF) mixture is needed. Finally a color coded square will lead you to the right mixture. One click on that specific mixture will lead  to the specific content elements. Here you can choose to use the guidelines specific prescription or adapt according to personal calories or fluid needs. The table will automatically calculate accordingly and show the fluid, nitrogen and calories prescription for the next 24 hours.

Results: We implemented this tool in our daily practice. By streamlining all variables and calculations the tool provides an easy to use method to improve patient safety as it reduces the error margin, efficiency is maximalized.

Conclusion: This tool enables us to do fast and guideline safe calculations for our pediatric population. It incorporates all the possible available mixtures and enables us to make an evidence-based decision according to the latest guidelines.

Disclosure of Interest: None declared