Nutrition in paediatric critical care

Optimal nutrition is a cornerstone of recovery for critically ill children in the paediatric critical care unit, influencing metabolic stability, immune function, and tissue repair. This paper explores current practices in paediatric critical care nutrition, examining the metabolic changes induced by critical illness, strategies for assessing energy and protein requirements and the challenges in implementing early enteral or parenteral nutrition. It highlights the role of a multidisciplinary healthcare team in ensuring appropriate nutritional interventions tailored to the child's evolving clinical status. This short article discusses key evidence, guidelines, and practical considerations for choosing the right feeding route and regimen, addressing concerns such as feed intolerance, delayed gastric emptying, and the risk of complications like aspiration and infection. Additionally, the timing of parenteral nutrition and its potential benefits when delayed are examined, as well as alternative feeding options, such as peptide-based formulas. This paper aims to provide a comprehensive overview of best practices for optimizing nutritional support in critically ill paediatric patients.