Nutrition in Pediatric Critical Care

Nutrition in Pediatric Critical Care is central to survival, metabolic stability, wound healing, immune function, and long-term recovery. Critically ill children often face heightened metabolic demands, feeding intolerance, organ dysfunction, and rapid physiologic changes that require precise nutritional assessment and delivery. This session examines evidence-based strategies for enteral, parenteral, and hybrid nutrition in ICU settings.

Critical care professionals regularly attend a Pediatrics Conference to deepen their understanding of energy requirements, protein targets, micronutrient needs, fluid balance, and feeding protocols. In this session, participants will explore how acute illness alters metabolic pathways, how to avoid underfeeding or overfeeding, and how to manage nutrition for children on mechanical ventilation, ECMO, renal support therapies, or with multi-organ dysfunction.

A major theme is strengthening pediatric critical care nutrition pathways to ensure structured assessments, timely feeding initiation, safe advancement, and regular monitoring. Case examples highlight nutritional challenges in sepsis, trauma, burns, postoperative states, congenital heart disease, and neurologic disorders. Participants will also learn strategies for identifying refeeding syndrome, managing electrolyte shifts, and ensuring gastrointestinal tolerance.

This session integrates family-centred care by reviewing how to involve caregivers in nutrition decisions, support breastfeeding in the ICU, and provide culturally sensitive guidance. Disparities in global access to specialised formulas, parenteral nutrition, and monitoring tools are also explored.

Core Themes in Pediatric Critical Care Nutrition

Metabolic responses to critical illness

  • Understanding catabolism, inflammation, and shifts in energy use.
  • Identifying nutritional risks that worsen morbidity.

Enteral and parenteral nutrition strategies

  • Initiating feeds early while ensuring safety and tolerance.
  • Selecting formulas and adjusting macronutrients to clinical needs.

Monitoring and adjusting nutrition plans

  • Tracking growth, labs, and feeding responses.
  • Recognising malnutrition or overfeeding early.

Nutrition in organ support therapies

  • Managing feeding for children on ventilation, ECMO, or dialysis.
  • Adapting plans to fluid restrictions and metabolic instability.

Practice Insights and ICU Nutrition Pathways

Designing structured ICU nutrition pathways
Standardising assessments, initiation timing, and advancement criteria.

Incorporating multidisciplinary input
Coordinating with dietitians, intensivists, surgeons, and nursing teams.

Supporting families in the ICU
Offering education and emotional support about feeding decisions.

Improving access in resource-limited settings
Using cost-effective feeding strategies and simplified monitoring tools.

 

Ensuring long-term recovery
Linking early nutrition to rehabilitation, growth, and neurodevelopment.

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