The TRANSPIRE Study: A prospective observational study to explore the relationship between nuTRition, protein intake ANd muScle mass loss during and after Pediatric Intensive caRE

Project Description

Around 20 000 children are admitted to PICU each year in the UK and Ireland and around 13,000 of these stay more than 3 days in intensive care, with some children staying a lot longer. As children’s intensive care in the UK has improved in the last decade, 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.

In adults in intensive care, research has shown that some of this muscle loss may be able to be lessened by given 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 physiologically. Furthermore, children admitted to intensive care 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 (by ultrasound, so using gel and running a probe over the muscle, which does not hurt at all) 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 also look at one of the routinely collected daily blood tests during the time the child is in intensive care (called an inflammatory marker) as well as collect information about their age and weight, why they came to intensive care and other important things that might impact on their muscles. We will do this in one intensive care unit, Alder Hey Children’s in Liverpool. This large PICU admits around 1200 children every year for lots of different reasons.

We have involved one of our past patients, who is now 21 years old and who spent around 3 months in our intensive care a few years ago. He and his family say that this (weight loss and weak muscles) was a real problem for him and his recovery, and he believes it is a really important area to investigate.