HN-00740060_Practical Approaches for Nutritional Management of Mechanically Ventilated Children

Introduction: Critically illness, particularly for patients who are mechanically ventilated, causes anorexia, increased catabolism and malnutrition. Specially, critically ill children are very susceptible to malnutrition, contributing longer duration of mechanical ventilation. Thus, nutritional therapy plays a critical role on admission and duration of mechanical ventilation in critically ill children. The aim of this study is to review the nutritional management of mechanically ventilated children.Methods: This study was performed by searching in Scopus, Web of Science, Medline, and PubMed. A combination of relevant mesh terms and key words was used for finding relevant articles. Search result was screened through abstracts and titles and finally relevant articles were included in the review. It was tried to evaluate all aspects of nutritional management of mechanically ventilated children.Results: Energy demand in mechanically ventilated children is controversial and the ideal method of calculating REE is indirect calorimetry, but in its absence, predictive equations may be used. Patients who receive adequate protein are more likely to be weaned from the ventilator and have a lower mortality rate. Protein demand should be determined individually and as per the latest ASPEN guidelines, a minimum protein intake of 1.5 g/kg/day is advised in these children. Also a balanced ratio of carbohydrates and lipids is advised. Moreover, individualized nutritional supplementation is one the treatment strategies in these children.Conclusion: Nutritional therapy may play a pivotal role in mechanically ventilated children and is as essential as other treatment modalities, because both under- and over-feeding are associated with adverse outcomes.

Keywords:

Critically ill children , mechanically ventilated children , Nutritional management