Nutritional support to patients within the pediatric intensive setting

Indirect Calorimetry Reveals That Better Monitoring of Nutrition Therapy in Pediatric Intensive Care Is Needed

“…Underfeeding, which stimulates use of endogenous fat stores, should reduce the RQ, whereas overfeeding, which results in lipogenesis, should increase the RQ. The metabolism of various substrates produces different RQ values: 1.0 for glucose, 0.7 for fat, and 0.85 for protein 26 . An RQ of 0.87 is shown to be optimal in critically ill pediatric patients 26 .…”

“…The metabolism of various substrates produces different RQ values: 1.0 for glucose, 0.7 for fat, and 0.85 for protein 26 . An RQ of 0.87 is shown to be optimal in critically ill pediatric patients 26 . Energy expenditure varies during critical illness, and failure to estimate energy requirements accurately may result in underfeeding or overfeeding of these patients 6 , 27 .…”

“…Both too much and too little protein, fat, and energy are associated with an impaired immune response to infections and wound healing, reduced gut function, decreased function of the respiratory muscles, and longer hospital stays 9 , 10 , 28 , 29 . By contrast, properly adjusted nutrition therapy is associated with improved outcomes in the treatment of these patients 26 , 30 …”

Zasady leczenia żywieniowego na oddziałach intensywnej terapii dziecięcej. Wspólne stanowisko towarzystw naukowych: Sekcji Anestezji i Intensywnej Terapii Dziecięcej PTAiIT, PTN, PTŻKD

“…Another tube should be simultaneously inserted into the stomach to decompress the retained gastric content and to evacuate air [59,64]. In both cases, the tube location should be radiologically confirmed, although auscultation is also acceptable when the tubes are inserted into the stomach.…”

“…Enteral nutrition, i.e., physiological nutrition, has many advantages [59,61,64], including: -preserved integrity and immune activity of the intestinal epithelium (production of IgA and T lymphocytes -70% of the body's lymphocytes are associated with the GI cell membranes); -prevention of bacterial translocation; -improvement of blood flow in the mesenteric vessels; -reduction in the number of infections; -prevention of GI mucosal atrophy; -maintenance of GI hormonal activity; and -lower costs, compared to parenteral nutrition.…”