TY - JOUR
T1 - Causes and consequences of inadequate substrate supply to pediatric ICU patients
AU - Hulst, Jessie M.
AU - Joosten, Koen F.
AU - Tibboel, Dick
AU - van Goudoever, Johannes B.
PY - 2006
Y1 - 2006
N2 - The prevalence of malnutrition among children admitted to a pediatric intensive care unit is still high. Assessment of nutrient supply is essential in the care of critically ill children because inadequate nutrition can increase morbidity and mortality. This review covers the causes and consequences of inadequate nutrient supply to critically ill children. A major factor contributing to the cause of inadequate nutrient supply is the difficulty in estimating nutritional needs of the individual child. Reasonable values for energy expenditure can be derived from prediction formulae but measuring energy expenditure by indirect calorimetry is useful in selected cases. Furthermore, under-prescription and inadequate delivery of nutrients caused by fluid volume restriction, procedural interruptions or cessation because of gastrointestinal intolerance or mechanical problems cause additional nutritional deficits. As routine nutritional assessment is lacking in many pediatric intensive care units, the ability to monitor the adequacy of nutritional support is poor. In the majority of children admitted to a pediatric intensive care unit, nutritional problems--both underfeeding and overfeeding--occur during admission due to poor estimation of nutritional needs, under-prescribing and problems in the delivery of the nutrients. Recommendations are made in order to prevent inadequate nutritional supply and its potentially harmful consequences in critically ill children
AB - The prevalence of malnutrition among children admitted to a pediatric intensive care unit is still high. Assessment of nutrient supply is essential in the care of critically ill children because inadequate nutrition can increase morbidity and mortality. This review covers the causes and consequences of inadequate nutrient supply to critically ill children. A major factor contributing to the cause of inadequate nutrient supply is the difficulty in estimating nutritional needs of the individual child. Reasonable values for energy expenditure can be derived from prediction formulae but measuring energy expenditure by indirect calorimetry is useful in selected cases. Furthermore, under-prescription and inadequate delivery of nutrients caused by fluid volume restriction, procedural interruptions or cessation because of gastrointestinal intolerance or mechanical problems cause additional nutritional deficits. As routine nutritional assessment is lacking in many pediatric intensive care units, the ability to monitor the adequacy of nutritional support is poor. In the majority of children admitted to a pediatric intensive care unit, nutritional problems--both underfeeding and overfeeding--occur during admission due to poor estimation of nutritional needs, under-prescribing and problems in the delivery of the nutrients. Recommendations are made in order to prevent inadequate nutritional supply and its potentially harmful consequences in critically ill children
U2 - https://doi.org/10.1097/01.mco.0000222115.91783.71
DO - https://doi.org/10.1097/01.mco.0000222115.91783.71
M3 - Article
C2 - 16607132
SN - 1363-1950
VL - 9
SP - 297
EP - 303
JO - Current Opinion in Clinical Nutrition and Metabolic Care
JF - Current Opinion in Clinical Nutrition and Metabolic Care
IS - 3
ER -