Nutrition in critically Ill pediatric patients: a systemic review

Abstract

Objective The study aimed to review the different types of nutrition in critically ill pediatric patients. Data sources Medline databases (PubMed, Medscape, Science Direct, EMF-Portal, Google Scholar) and all materials available in the Internet from 2001 to 2014 were searched. Study selection The initial search presented 150 articles of which 50 met the inclusion criteria. The articles studied the role of nutritional management in critically ill pediatric patients. Data extraction If the studies did not fulfill the inclusion criteria, they were excluded. Study quality assessment included whether ethical approval was gained, eligibility criteria specified, adequate information provided, and assessment measures defined. Data synthesis Comparisons were made by structured review with the results tabulated. Findings In total, 50 studies indicated that ICU patients who present with malnutrition or at a high probability of developing malnutrition during their hospital stay and those who are not expected to be on a full oral diet within 3 days should receive specialized enteral and/or parenteral nutritional support. Feeding should be started early within the first 24–48 h to facilitate diet tolerance and reduce the risk of intestinal barrier dysfunction and infections. Conclusion This review found that critically ill pediatric patients are at risk of malnutrition. Enteral nutrition is the preferred mode of nutrition and should be used whenever possible. Total parental nutrition is used only if the gastrointestinal tract is unable to meet the nutritional requirements for 1–3 days in infants and 4–5 days in children and adolescents.