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Research project

PEPaNIC follow-up

Status: Ongoing

Children’s long-term neuropsychological outcome after caloric restriction during the first week of critical illness.

What we do

About our project

Background information 

It is thought that tolerating caloric deficits early during critical illness has 'carry-over' effects, through epigenetic changes, that improve former critically ill children’s long-term (neurocognitive) outcomes.

Overall aim 

The aim of the PEPaNIC long-term outcome study is to determine the long-term neurocognitive outcome (more specifically the IQ-scores, motor and executive function) of critical illness and the effect hereon of artificial nutrition provided during the acute phase of critical illness in children.

Research method 

A longitudinal cohort study of the critically ill children from the international, multicentre PEPaNIC randomised controlled trial will be performed. Long-term impact will be performed by anthropometric and neurocognitive assessments at 2 and 4 years after inclusion in the PEPaNIC study patients and in age-matched healthy children.

Desirable outcome

We hypothesise that, in comparison with the current practice of aggressive nutritional support, tolerating caloric deficits early during critical illness in critically ill children has “carry-over” effects, through epigenetic changes, that improve long-term (neurocognitive) outcomes.



Collaborations outside of Erasmus MC

University Hospitals, Belgium, Leuven.

Stollery Children’s Hospital, Canada, Edmonton.


Impact of withholding early parenteral nutrition completing enteral nutrition in pediatric critically ill patients (PEPaNIC trial): study protocol for a randomized controlled trial.
Tom Fivez, Dorian Kerklaan, Sascha Verbruggen, Ilse Vanhorebeek, Sören Verstraete, Dick Tibboel, Gonzalo Garcia Guerra, Pieter J Wouters, Ari Joffe, Koen Joosten, Dieter Mesotten & Greet Van den Berghe. (2015). Journal ListTrialsv.16; 2015 PMC4422419.

Early versus Late Parenteral Nutrition in Critically Ill Children.
Tom Fivez, M.D., Dorian Kerklaan, M.D., Dieter Mesotten, M.D., Ph.D., Sascha Verbruggen, M.D., Ph.D., Pieter J. Wouters, M.Sc., Ilse Vanhorebeek, Ph.D., Yves Debaveye, M.D., Ph.D., Dirk Vlasselaers, M.D., Ph.D., Lars Desmet, M.D., Michael P. Casaer, M.D., Ph.D., Gonzalo Garcia Guerra, M.D., Jan Hanot, M.D., Ari Joffe, M.D., Dick Tibboel, M.D., Ph.D., Koen Joosten, M.D., Ph.D., and Greet Van den Berghe, M.D., Ph.D.et al. (2016). N Engl J Med. 2016 Mar 24;374(12):1111-22.