title: Impact of early enteral nutrition therapy on morbimortality reduction in a pediatric intensive care unit: a systematic review.
abstract: OBJECTIVE
  To assess the impact of early introduction of enteral nutrition therapy in reducing morbidity and mortality in pediatric intensive care unit.
  
  
  METHODS
  Search in the literature of the last 10 years, in English and the target population of individuals aged 1 month to 18 years admitted to pediatric intensive care units in the databases PubMed, Lilacs and Embase using the keywords: Critical Care, Nutritional Support and Nutrition Disorders or Malnutrition.
  
  
  RESULTS
  Despite advances in the quality of clinical care, the prevalence of malnutrition in hospitalized children remains unchanged in the last 20 years (15-30%) and has implications for the time of admission, course of illness and morbidity. Malnutrition is common and is often poorly recognized and therefore, untreated. Nutritional therapy is an essential part in the treatment of pediatric patients who have severely ill hypercatabolic state protein, which can be minimized with an effective nutritional treatment plan. In this study, we reviewed publications which have shown that there is still a paucity of randomized and controlled studies with good statistical treatment in relation to enteral nutritional therapy with outcomes related to morbidity and mortality. The current guidelines for nutritional therapy in these patients are largely based on expert opinion and data extrapolated from adult studies and studies in healthy children.
  
  
  CONCLUSIONS
  The scientific evidence on the use of enteral nutrition therapy in improving the development of critically ill pediatric patients is still scarce and further studies are needed focusing on it, and better guidelines must be formulated.
authors.affiliation: Ambulatório de Especialidades, Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil; Departamento de Pediatria, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil. Electronic address: fernanda.marchetto@gmail.com.
authors.forename: Fernanda Marchetto da
authors.initials: FM
authors.lastname: Silva
authors.forename: Ana Carolina Gouvea
authors.initials: AC
authors.lastname: Bermudes
authors.forename: Ivie Reis
authors.initials: IR
authors.lastname: Maneschy
authors.forename: Graziela de Araújo Costa
authors.initials: Gde A
authors.lastname: Zanatta
authors.forename: Rubens
authors.initials: R
authors.lastname: Feferbaum
authors.forename: Werther Brunow de
authors.initials: WB
authors.lastname: Carvalho
authors.forename: Uenis
authors.initials: U
authors.lastname: Tannuri
authors.forename: Artur Figueiredo
authors.initials: AF
authors.lastname: Delgado
mesh_terms: D001938:Brazil / Q000453:epidemiology; D002648:Child; D016638:Critical Illness / Q000401:mortality / Q000628:therapy*; D004750:Enteral Nutrition; D005500:Follow-Up Studies; D006801:Humans; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data*; D007902:Length of Stay; D044342:Malnutrition / Q000453:epidemiology / Q000517:prevention & control*; D044623:Nutrition Therapy / Q000592:standards*; D010288:Parenteral Nutrition; D016032:Randomized Controlled Trials as Topic
keywords: Care; Child mortality; Cuidados críticos; Desnutrição; Malnutrition; Mortalidade na infância; Nutritional therapy; Terapia nutricional