Current Concepts in Pediatric Critical Care-15. Nutrition

Video Transcription

Video Summary

In this video presentation, the speaker discusses the 2017 Nutrition Guidelines for critically ill children in the pediatric intensive care unit (PICU). The guidelines were developed by a multidisciplinary task force and aim to improve nutrition therapy in these patients. The speaker highlights the importance of addressing malnutrition in PICU patients, as studies suggest that up to 60% of these children are malnourished. Malnutrition poses a risk for infection, longer ICU stays, prolonged ventilation, and increased mortality. The guidelines provide recommendations for nutrition therapy, including energy and protein requirements, which are higher than the Recommended Daily Allowance values. Indirect calorimetry is recommended to determine energy needs, although it may not be accessible in all settings. Enteral nutrition is the preferred method of feeding, and gastric feeds are preferred over small bowel feeds. The use of algorithms or protocols is advocated to guide the initiation and advancement of feeds and to minimize interruptions. The guidelines do not recommend the use of immunonutrition in PICU patients due to a lack of evidence. The speaker emphasizes the need for ongoing monitoring and reassessment of the patient's nutritional status to ensure that goals are being met.

Asset Caption

Sharon Y. Irving, PhD, CRNP, FCCM, FAAN, FASPEN

Keywords

Nutrition Guidelines

critically ill children

pediatric intensive care unit

malnutrition

enteral nutrition

energy and protein requirements

indirect calorimetry

immunonutrition

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