Proefschrift Kerklaan

Chapter 2

MATERIAL AND METHODS

The local Institutional Review Board of the Erasmus MC in Rotterdam waived the need for consent. The participation in this survey was voluntary, and no patient identifiers were collected. The cross-sectional survey was conducted between July and November 2013. The online questionnaire was composed of 59 questions regarding local nutritional protocols and strategies, and provided in English, French, Spanish and Chinese. The second part, the point prevalence , conducted between May and September 2014, involved data collection on nutritional practices and intake for the preceding 24 hours. In a subgroup of centers that agreed to participate in this portion of the study, respondents were asked to include data for all patients present in their PICU; no selection criteria were applied. Both questionnaires are available as an online supplement (Supplementary Digital Content: http://links.lww.com/PCC/ A204). Testing of clarity, relevance, and clinical sensibility of the English questionnaire was performed by independent clinicians in three centers (Sophia Children’s Hospital-Erasmus MC, Rotterdam, the Netherlands; University Hospital of Leuven, Belgium; and the Boston Children’s Hospital, Boston, MA). Data from this test were not included in the final analysis and survey results. Afterward, the questions were translated to French, Spanish, and Chinese by native speakers. An invitation to the survey was electronically distributed to members of the World Federation of Pediatric Intensive and Critical Care Societies (WFPICCS) by their mailing list and to specific members of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC) and Society of Critical Care Medicine involved in nutritional management and through the newsletter of both the ESPNIC andWFPICCS and the WFPICCS homepage and LinkedIn group. A reminder was sent 2 months after the first invitation. Due to incomplete data registration, the exact number of PICUs represented by the WFPICCS database is unknown. Respondents who provided their contact information in the survey, were approached to participate in the point prevalence . If more than one questionnaire was returned from a single PICU, the answers were weighted by the inverse of the number of completed questionnaires per center, in order to process conflicting statements within a single institution without disrupting the weight of the answers per PICU. Countries were classified by income according to The World Bank income groups 16 . Individual questions were stratified by continent, income of country, number of PICU beds, admissions per year, and percentage of ventilated patients. Statistical analysis was performed using IBM SPSS statistics 21 for Windows (IBM, Chicago, IL). Descriptive statistics were used to compare differences in respondent characteristics and survey responses. Nutritional data obtained in the point prevalence were compared to

34