More and sooner, but not necessarily better

Abstract

Critically ill children have generalized nutrition compromise. The timing of parenteral nutrition (PN) initiation has been under debate in both adults and children. A recent report of a multi-national randomized control trial in children demonstrated clinical superiority of delaying initiation of parental nutrition, and was associated with improved clinical outcomes and a lower rate of infection. In this editorial, we discuss our communication with the authors and our experience in a large cardiac intensive care unit (CICU) in the United States where improved nutrition delivery, and early PN, has improved weight-for-age z-score (WAZ) but has not shown any difference in length of hospital stay or reduced ventilator times.