Jessie Hulst, Staff Gastroenterologist, MD, PhD

Department of Pediatrics, Division of Gastroentrology, Hepatology and Nutrition
The Hospital for Sick Children

Dr Jessie Hulst is a staff gastroenterologist in the Division of Gastroenterology, Hepatology and Nutrition of The Hospital for Sick Children in Toronto and an Associate Professor in the Department of Pediatrics and Department of Nutritional Sciences of the University of Toronto. Before joining Sickkids in July 2018, she was a Staff Gastroenterologist in Erasmus Medical Center, Sophia Children’s Hospital, Rotterdam in the Netherlands, from 2011-2018. Jessie obtained her PhD on the topic of nutritional assessment in critically ill children in 2004, and has been involved in both national and international research about this topic since. In 2009, she developed a simple nutritional risk screening tool (STRONGkids), which is used in multiple hospitals around the world. Her research interests are also focused on nutritional status and body composition in relation to disease in various pediatric patient groups. She has published >75 peer-reviewed manuscripts and >10 book chapters. Furthermore, she is involved in several national and international working groups related to pediatric nutrition. As the Chair of Pediatric section of the Dutch Malnutrition Taskforce she was involved in the development and implementation of a nationwide pediatric malnutrition pathway. In Sickkids, Jessie is currently running a complex Nutrition clinic and EoE clinic, she is the hospital PN medical lead and the chair of the Nutritional Advisory Committee. She is also the co-chair of the Pediatric working group of the Canadian Malnutrition Task Force and working on the design and implementation of a pediatric Malnutrition Pathway in Canada.

Vitamin and Trace Element (VTE) Status in Sick Children – new assessment algorithm for clinic practice.

The assessment and monitoring of the vitamin and trace element (VTE) status is important in the clinical management of the sick child, because VTE deficiencies are prevalent and timely identification and treatment can influence outcome. Reasons for VTE deficiencies and related indications for the screening of VTE status will be covered. There are three main approaches to assess the VTE body status of an individual patient including clinical examination, dietary assessment and measurement of direct and indirect biomarkers of VTE in biological samples – these methods will be discussed. It is however important to realize that the interpretation of especially the biomarker results can be very challenging and potentially mislead clinical practice because of influencing factors such as systemic inflammatory response, disease-related changes and the lack of paediatric reference intervals. The use of a multimodal approach (VTE algorithm) proposed by the Nutrition Committee of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition, will be presented to help guide clinicians in the assessment of VTE status of individual patients. Clinical cases of children with chronic disease (jejunal feeds and long-term PN) will be discussed.