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Table 2 Barriers for de-implementation (> 1 answer per PICU possible) in the 33 PICUs that have partially or not de-implemented early administration of PN

From: International survey of De-implementation of initiating parenteral nutrition early in Paediatric intensive care units

Barriers No of PICUs (n = 33)
Safety issues
 Not convinced of the safety and/or efficacy in undernourished children 17
 Convinced that critically ill children need amino acids in the acute phase of illness 15
 Not convinced of the safety and/or efficacy in neonates 11
 Convinced that critically ill children need lipids in the acute phase of illness 6
 Not convinced of the safety in general 4
 Convinced that critically ill children need more glucose in the acute phase of illness 2
Confirmation of results
 Waiting for updated international guidelinesa 11
 Waiting for replicating studies 11
 Waiting for long term results 8
 Don’t consider these results to be cost-effective 1
Structural reasons
 Non-consensus within staff 9
 Otherb 5
 Lack of nutritional protocol 2
 Because of logistic reasons (i.e. arrangements with pharmacy) 1
Total number of reasons 103
  1. PICU paediatric intensive care unit, PN parenteral nutrition
  2. aRespondents from Europe: n = 7, North America: n = 2, South America: n = 2 and Africa: n = 1
  3. bProvided answers: the PEPaNIC results are not generalizable to our PICU: n = 3; PN is administrated rarely in our centre: n = 1; we are currently changing our PN strategies: n = 1