Nutritional Assessment in the Critically Ill Child

Malnutrition is highly prevalent in critically ill children. Several studies have recently reinforced the relationship between poor nutritional status and higher incidences of complications, mortality, length of hospital stay and costs. A variety of methods used for assessment of different components of energy expenditure has been validated and used in critically ill children. Although reference values derived from representative groups of healthy children and adolescents are now available, hypercatabolism along with hypometabolism or hypermetabolism is frequently seen in critically ill children. Methods for assessment of the different components of energy expenditure have been validated in critically ill children and adolescents. There are, however, significant disadvantages of the available tools and of the methodological aspects of assessment of energy expenditure in a pediatric intensive care setting. The combined use of these methods together with detailed analyses of body composition is recommended for future studies. Although, the evaluation of nutritional status is a broad topic that encompasses several clinical variables, in patients with acute critically illness measurements of energy expenditure are necessary.