Background Ventilator dependency constitutes a major problem in the intensive care setting. Malnutrition is considered a major determinant of extubation failure, however, attention has been attracted to modulating carbon dioxide production through decreasing carbohydrate loading and increasing the percent of fat in enteral feeds. The detected interrelation between substrate oxidation and ventilation outcome became the base of several research to determine the appropriate composition of the nonprotein calories of diet in ventilated patients.Purpose We aimed to assess the effect of high-fat dietary modification and nutritional status on ventilatory and final outcomes of pediatric intensive care.Methods Fifty-one ventilated children (1 month to 12 years of age) with pulmonary disease who could be enterally fed, in the Cairo University Pediatric intensive care unit, were divided into 2 groups: group A included 25 patients who received isocaloric high-fat, low-carbohydrate diet; group B included 26 patients who received standard isocaloric diet. Comprehensive nutritional assessment was done for all patients.Results Group A had a significant reduction in carbon dioxide tension, but no similar reduction in the duration or level of ventilatory support. Assisted minute ventilation was predicted by weight-for-age and caloric intake rather than the type of diet. Poor nutritional status was associated with higher mortality and lower extubation rates. Mild hypertriglyceridemia and some gastrointestinal intolerance were significant in group A, with no impact on the adequacy of energy or protein delivery.Conclusion The high-fat enteral feeding protocol may contribute to reducing carbon dioxide tension, with mild hypertriglyceridemia and negligible gastrointestinal intolerance as potential adverse effects. Optimization of nutritional status rather than dietary modification may improve ventilatory and survival outcomes in critically ill-ventilated children.

Background: Childhood obesity is one of the most serious public health challenges of the 21st century. Its prevalence has increased at an alarming rate according to recent WHO reports. Some studies suggest this increase to changes in diet patterns with the shift to a processed low-fiber diet. Dietary fiber has shown different protective health benefits against obesity and its comorbidities. Current dietary fiber intake status in obese children and adolescents is understudied. Aim of the work:  to assess the adequacy of fiber intake in obese children and adolescents. Methods: A observation of a group of obese pediatric patients. All included patients were subjected to detailed medical history and clinical examination obtained from interviews with them or their medical records with special emphasis on anthropometric measures in form of weight, height and waist circumference, age of diagnosis, dietary intake, lifestyle, drugs, and possible complications. Dietary assessment through 24 h recall from all participants with an analysis of fiber according to 2nd Edition food composition tables for Egypt of National Institute of Nutrition Results: obese children and adolescents in the current study consumed less than 25% of their daily required intake.