ABSTRACT
Provision of adequate nutritional support to infants and children in the intensive care unit (ICU) should initially focus on minimizing the effects of the acute phase of critical illness. It has been estimated that 15 to 20% of all pediatric patients admitted to the ICU have preexisting malnutrition.1
Malnutrition is associated with the depletion of protein and fat stores, reduced immunocompetence, increased risk of infection, poor wound healing, and increased morbidity and mortality.2 Protracted catabolic stress in children who have reduced body stores, higher baseline energy requirements, or malnutrition may have devastating effects. Secondary goals should include the provision of adequate protein to promote positive nitrogen balance and to preserve lean muscle tissue. Finally, nutritional support should be designed to promote anabolism and growth in the convalescent stage of critical illness. This is one of the key differences in the care of critically ill children and adults.
