Nutritional approach in pediatric intensive care unit

Abstract

AIMS: To review the nutritional approach of critically ill children, emphasizing prior malnutrition as a factor in its severity, and anthropometric nutritional assessment methods commonly used in pediatric intensive care units. SOURCE OF DATA: The following descriptors were elected: malnutrition, intensive care units, pediatrics, nutrition assessment and nutritional requirements (and their corresponding Portuguese terms). We conducted a search in databases Medical Literature Analysis and Retrieval System Online (Medline), Web of Science and Scientific Electronic Library Online (SciELO), from August 2009 to March 2013. SUMMARY OF FINDINGS: Malnutrition persists mainly in critically ill pediatric patients, representing an increased risk of mortality and longer hospital stay. A method regarded as the gold standard for assessing nutritional status in Pediatric Intensive Care Unit was not described to date. However, anthropometry is widely used and is considered a good method. There are several ways to estimate the nutritional needs of critically ill children. Weight and age are frequently used, followed by predictive equations. CONCLUSIONS: Malnutrition is a problem that remains in the hospital environment, especially in critically ill pediatric patients. The anthropometric nutritional assessment is widely used in Pediatric Intensive Care Units, and is usually the method of choice. The Schofield equation is a good method to be used, because it establishes the baseline energy expenditure