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Roudi F, Dehnavi Z, Khademi G. Practical Approach to Nutritional Management of Mechanically Ventilated Children: A Review. J. Pediatr. Rev. 2021; 9 (2) :4-4
URL: http://jpr.mazums.ac.ir/article-1-350-en.html
1- Nutrition Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
2- Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. , Khademigh@mums.ac.ir
Abstract:   (839 Views)
Context: Malnutrition is associated with longer duration of mechanical ventilation and increased risk of healthcare-acquired infections in critically ill children who are mechanically ventilated. Therefore, nutritional therapy plays a pivotal role in the initiation and duration of mechanical ventilation, and clinical outcomes in such patients.
Evidence Acquisition: This review was conducted by searching in Web of Science, Scopus, Embase, and Medline databases. A combination of related mesh terms and key words was used to find relevant articles. Finally, we screened search results through titles and abstracts and related articles were enrolled to the review process. We tried to address all aspects of nutritional management of mechanically ventilated critically ill children.

Results: Energy demand in mechanically ventilated children is a controversial issue and Indirect Calorimetry (IC) is the recommended method to measure resting energy expenditure (REE); however, in the absence of IC, predictive equations may be used. A minimum protein intake of 1.5 g/kg/day and a balanced diet in other macronutrients ratio including carbohydrates and lipids would be appropriate for mechanically ventilated children. However, the administration of major substrates should be based upon the patient’s metabolism regarding the nature and phase of the illness. Moreover, individualized nutritional supplementation is one of the treatment strategies in these children.
Conclusions: Optimum, individualized nutrition support of mechanically ventilated children is considered as a major therapeutic strategy and an essential aspect of their medical management. Further large population-based studies are required to provide appropriate feeding protocols for preventing nutritional inadequacy in such patients.
     
Type of Study: Review Article | Subject: Pediatric Intensivist
Received: 2020/07/16 | Accepted: 2020/10/22 | Published: 2021/04/21

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