A prospective observational study to explore the relationships between nutrition, protein intake and muscle mass loss during and after Pediatric Intensive care: the TRANSPIRE Study

Around 20 000 children are admitted to intensive care each year in the UK and Ireland and around 13 000 of these stay more than 3 daysin intensive care, with some children staying a lot longer. Almost all children now survive critical illness, but for many, their recovery is prolonged both physically and psychologically. Children on the breathing machine in intensive care lose a lot of weight and muscle very quickly, and this slows down their recovery and can lead to longer stays both in the intensive care and in hospital. Critically ill adult research shows that some of this muscle loss may be able to be lessened by giving them a higher protein feed combined with early rehabilitation in intensive care, but in children we still do not know if this weight and muscle loss is modifiable by and related to the nutrition and the amount of protein they receive. This is what we want to find out, as children are not the same as adults, and frequently respond in different ways to adults. Furthermore, children admitted to ICU are quite different both in their age range and underlying conditions to those of adults. To do this, we want to look at the children’s muscles when they first come to intensive care, every few days, when they leave intensive care, when they leave the hospital and 3 months later. We will then see what happens to their muscles and how strong their muscles are, as well how much nutrition and protein they got in intensive care to see if they are related. We will study this in one intensive care unit, Alder Hey Children’s NHS Trust in Liverpool. This is a prospective observational single centre study to determine the association between muscle mass loss and function, nutrition, and protein intake during and after pediatric critical illness.

Funder: NIHR RfPB £157 698

Team: Lyvonne N Tume (Chief Investigator), Paul Comfort, Lynne Latten, Frederic V Valla, Chao Huang, Anand Wagh, Vanessa Compton, Archie Veale, Lewis Veale.