Nutrition in Critically Ill Children

Abstract

Nutritional management of critically ill children (CIC) is a very specialist and challenging area in paediatric practice. A knowledge of metabolic changes and fuel utilisation during physiological stress can assist dietitians in commencing nutritional support at the appropriate time and suggesting a suitable feeding route and feed composition. Critical illness is characterised by a cascade of endocrine and metabolic reactions, affecting all major organs. During critical illness immune cells, e.g. macrophages, lymphocytes and neutrophils, regulate the inflammatory response through the release of cytokines and chemokines. Anthropometry, biochemical markers, clinical and dietary review form part of the nutritional assessment in CIC. This chapter describes the effect of nasogastric versus nasojejunal feeding and continuous feeds versus bolus feeding. A probiotics is a live microbial feed supplement which beneficially affects the host by improving its intestinal microbial balance.