PROTOCOL NUTRITION THERAPY OF CRITICALLY ILL CHILDREN

Area of Science:

• Pediatric Intensive Care Medicine
• Clinical Nutrition
• Nutritional Support

Background:

• Critical and post-aggressive states in children, especially during intensive growth periods like the first year of life, are characterized by malnutrition.
• Existing protocols may lack comprehensive guidance for nutritional management in pediatric intensive care.

Purpose of the Study:

• To establish a flexible framework for diagnostic criteria and therapeutic actions in pediatric intensive care nutrition.
• To provide evidence-based recommendations for both parenteral and enteral nutrition in critically ill children.
• To empower clinicians with defined guidelines while allowing for individualized patient care.

Main Methods:

• The protocol details contraindications and indications for artificial nutrition, including parenteral and enteral routes.
• It specifies components, calculations for water, energy, and substrate requirements for parenteral nutrition.
• Methods for monitoring effectiveness, using "two-in-one" and "three-in-one" systems, and incorporating adjuvants are described.

Main Results:

• The protocol provides a structured approach to nutritional support, covering artificial nutrition contraindications and indications.
• It details the components and calculations necessary for parenteral nutrition, including advanced delivery systems.
• Guidelines for early enteral nutrition, including timing, tolerance, feeding techniques, and formula selection, are comprehensively outlined.

Conclusions:

• This protocol offers a non-directive framework for nutritional management in pediatric intensive care, respecting clinical judgment.
• It addresses critical aspects of malnutrition in critically ill children, particularly during early life stages.
• The protocol emphasizes a systematic approach to parenteral and enteral nutrition, enhancing patient care outcomes.