Nutritional support in malnourished paediatric patients

Area of Science:

• Clinical Nutrition
• Pediatric Critical Care
• Metabolic Disorders

Background:

• Protein energy malnutrition (PEM) exacerbates underlying diseases, particularly in critically ill patients with sepsis.
• Rapid malnutrition can occur in critical illness, creating a detrimental cycle with worsening PEM.
• Severe PEM leads to homeostatic changes, increasing risks associated with nutritional interventions.

Purpose of the Study:

• To examine the consequences of PEM.
• To outline methods for providing appropriate nutritional support.
• To identify risks for severely malnourished pediatric patients during hospitalization.

Main Methods:

• Review of consequences of PEM.
• Discussion of enteral nutrition as a primary feeding route.
• Analysis of parenteral nutrition (PN) indications and associated risks.

Main Results:

• Enteral nutrition is preferred when the gastrointestinal tract is functional.
• Parenteral nutrition (PN) is necessary when nutritional requirements cannot be met enterally.
• PN is associated with a high risk of metabolic complications, including refeeding syndrome.

Conclusions:

• Appropriate nutritional support is crucial for catch-up growth in malnourished patients.
• Body composition changes must be monitored during nutritional rehabilitation.
• Understanding and managing refeeding syndrome is critical in patients receiving PN for severe PEM.