title: Optimal nutrition in the paediatric ICU.
abstract: OBJECTIVE
  This article describes the current best available evidence on optimal nutrition in the paediatric intensive care based on different levels of outcome, which can be divided in surrogate and hard clinical outcome parameters.
  
  
  RESULTS
  Undernutrition is associated with increased morbidity and mortality, whereas in specific cohorts of critically ill children, such as those with burn injury, obesity is associated with more complications, longer length of stay, and decreased likelihood of survival. There is a relation with adequacy of delivery of enteral nutrition and the amount of protein on length of hospital stay, neurological status, and mortality. Studies relating organ function, other than skin healing after thermal injury, with the nutritional status are scarce. There is also a scarcity of data concerning long-term follow-up and health economics.
  
  
  CONCLUSIONS
  Until now, there are no randomized controlled trials which have investigated a causal relation between different feeding regimens on the nutritional status and short and long-term outcome. As a result current optimal nutritional strategies are based on small trials with surrogate outcome parameters. Prospective randomized studies are needed with nutritional and/or metabolic interventions to come to an optimal feeding strategy for critically ill children.
authors.affiliation: ErasmusMC-Sophia Children's Hospital, Department of Paediatric Intensive Care, Dr Molewaterplein 60, 3015 GJ Rotterdam, The Netherlands.
authors.forename: Koen
authors.initials: K
authors.lastname: Joosten
authors.forename: Esther
authors.initials: E
authors.lastname: van Puffelen
authors.forename: Sascha
authors.initials: S
authors.lastname: Verbruggen
mesh_terms: D000596:Amino Acids / Q000008:administration & dosage; D001823:Body Composition; D002648:Child; D016638:Critical Illness / Q000628:therapy*; D004044:Dietary Proteins / Q000008:administration & dosage / Q000378:metabolism; D002149:Energy Intake; D004750:Enteral Nutrition / Q000191:economics / Q000379:methods*; D006801:Humans; D015278:Intensive Care Units, Pediatric; D007902:Length of Stay; D008066:Lipolysis; D009124:Muscle Proteins / Q000378:metabolism; D009752:Nutritional Status; D010288:Parenteral Nutrition / Q000191:economics / Q000379:methods*; D014176:Protein Biosynthesis; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
chemical_list: D000596:Amino Acids; D004044:Dietary Proteins; D009124:Muscle Proteins