The metabolic and nutritional response to critical illness

Nutrition Delivery Affects Outcomes in Pediatric Acute Respiratory Distress Syndrome

“…1,2 Thus, adequate energy and protein intake are important to buffer these stressinduced changes. 6,25 Our data are consistent with previous observational studies demonstrating a reduction in PICU mortality in patients with ARDS with improved caloric and protein delivery. A multicenter study involving 500 intubated PICU patients demonstrated that patients who received >66% of prescribed calories via EN had lower 60-day mortality compared with those who received <33% prescribed calories (OR, 0.14; 95% CI, 0.03-0.61; P = .002).…”

Predicted versus measured energy expenditure by continuous, online indirect calorimetry in ventilated, critically ill children during the early postinjury period*

“…Because the period of time for patient study initiation was short (median, 1 hr), we managed to study the energy expenditure during the early postinjury period. We chose this well-defined period of time because we wanted to ensure that all our patients were in the same postinjury phase (it is known that the energy expenditure varies according to the stress response phase (41)). Second, we wanted to assess nutritional requirements during the early postinjury period because there is an increasing interest in knowing how to determine nutritional support needs in critically ill patients during this time (42,43).…”

Nutrition Therapy in a Pediatric Intensive Care Unit

“…[1][2][3] Critically ill children have a high risk of malnutrition because of stress-induced changes in intermediary metabolism; these changes are characterized by an increased basal metabolic rate and intensive protein catabolism. [4][5][6] In general, the development or perpetuation of malnutrition during hospitalization in the PICU is due to illness, unknown nutrition condition, and an inadequate supply of nutrients. 7,8 In these patients, malnutrition is associated with physiologic instability.…”