Supplemental Parenteral Nutrition in Pediatric Respiratory Failure

Exclusion Criteria

• •1. Premature infants and neonates \< 37 weeks corrected gestational age,
• •2. Transfer patient on an established enteral or parenteral nutritional regimen,
• •3. Known allergy to lactulose or mannitol,
• •4. Pregnant,
• •5. Admit BMI \>30,
• •6. Thoracic trauma, abdominal trauma, and/or active intracranial bleeding,
• •7. Anuric renal failure, previous bowel surgery and/or short gut syndrome,
• •8. Cannot be enterally fed within 24 hours of admission according to the admitting physician,
• •9. On extracorporeal membrane oxygenation (ECMO),
• •10. Expected survival \<24 hours or limitations to aggressive ICU care (DNR),
• •11. Receiving active CPR when admitted to the PICU,
• •12. A pre-existing bronchopleural fistula,
• •13. Previously enrolled and randomized into this protocol,
• •14. Actively enrolled in another clinical trial which at the discretion of the PI would conflict with this study.