Objective To investigate the influencing factors for energy balance and the relationship between energy balance and clinical outcome in PICU mechanical ventilation children. Methods Children with mechanical ventilation who were hospitalized in PICU for more than 3 days from June 2015 to May 2016 were collected, resting energy expenditure was measured by resting energy metabolic detector, and the nutrition balance was calculated, the influencing factors on energy balance was analyzed by regression analysis. Results A total of 104 mechanical ventilation children were included with the average energy consumption of (265.4±63.2)kJ/kg in the first 3 days and the average energy supply of (219.8±82.9)kJ/kg, and failed to reach the target value (P<0.05). As the time of hospitalization was prolonged, the supply of energy increased gradually, the SAPS Ⅱ (r=-0.609, P=0.000), mechanical ventilation time (r=-0.456, P=0.000), ICU stay time (r=-0.646, P=0.000), the number of organ failure(r=-0.568, P=0.000), infection complications (r=-0.859, P=0.000) were negatively correlated to energy supply balance; regression analysis showed that complications of nosocomial infection (P=0.000), number of organ failure (P=0.000), mechanical ventilation time (P=0.000), ICU retention time (P=0.001) were predictors of energy supply balance. Conclusion Insufficient supply of energy for the first three days of mechanical ventilation is high in the critically ill children. Factors affecting energy supply balance include patient's organ failure, infection complications, mechanical ventilation time, and ICU retention time, which suggest that the strengthening of the nutritional management of the critically ill children with mechanical ventilation will benefit to the clinical outcome. Key words: Nutritional risk; Resting energy; Mechanical ventilation; Energy balance

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