Impact of early enteral nutrition therapy on morbimortality reduction in a Pediatric Intensive Care Unit: A systematic review

Sondagem enteral em crianças: a realidade de uma enfermaria de lactentes / Enteral tube in children: the reality of an infant nursery

“…Most severely ill children have a state of protein hypercatabolism, with high consumption of endogenous reserves, which can be minimized with nutritional therapy. 4 Indication of the use of gastric or jejunal tubes will depend on the following conditions: presence or risk of malnutrition; Prolonged fasting; Congenital anomalies; Partial, functional or mechanical obstruction of the upper digestive tract; trauma; Sepsis; Neoplasms; Large burns; Neurological impairment and/or high bronchial aspiration probability; with the; Traumatic brain injury; Difficulty or inability to suck and swallow; gastroesophageal reflux; Respiratory failure and mechanical pulmonary ventilation. 1 When comparing the variables of the types of probe used, we observed a significant number of choice for the jejunal probe, which is best indicated for children at risk of regurgitation and bronchoaspiration.…”

“…Therefore, nutritional therapy by gastric or jejunal route should be instituted within the first 24 to 48 hours after admission, when oral feeding is not possible, to avoid the effects and impact of hospitalization on children, nutritional impairment and long periods, which is extremely detrimental to the pediatric patient. 1,4 There are two forms of nutritional therapy: enteral and parenteral. Enteral therapy uses the gastrointestinal system, considered from oral feeding or by catheter with gastric or jejunal topography.…”

Nutritional management in the critically ill child with acute kidney injury: a review

“…Multiple studies on critically ill children in the PICU confirm the high risk of protein/energy debt, especially in the first few days of the patient's stay in the PICU, and protein debt appears to be the more common and important disorder [1,[4][5][6]. In their retrospective analysis of 167 critically ill children, Kyle et al showed that underfeeding was accentuated in the children with AKI and that protein underfeeding was greater than energy underfeeding in the first 5 days of ICU stay [4].…”

“…The objectives of this review are: (1) to review the pathological mechanisms underlying protein-energy wasting in an AKI setting; (2) to understand the importance of nutrition in critically ill children with AKI; (3) to understand the nutritional challenges in treating a child with AKI in the PICU; (4) to review the methods of assessing nutritional status in a sick child; (5) to review the dietary requirements of a critically ill child with AKI (including those on RRT), including protein, energy, vitamins, and minerals; (6) to review the evidence for the benefit of enteral and intradialytic parenteral nutrition.…”

Resposta inflamatória sistêmica e alterações no metabolismo lipídico em crianças e adolescentes gravemente doentes

“…Uma revisão de literatura realizada em adultos por Zaloga (1999) mostrou que a maioria dos estudos controlados e prospectivos apoia a ideia de que a terapia nutricional enteral precoce melhora os resultados clínicos em pacientes gravemente doentes. Uma revisão sistemática realizada na mesma instituição onde foi feito nosso trabalho para avaliar o impacto da introdução precoce de terapia nutricional enteral na redução da morbimortalidade em unidades de terapia intensiva pediátrica mostrou que há escassez de pesquisas controladas e randomizadas nesta área sendo os achados extrapolados de estudos realizados em adultos (Silva, et al,2013). A PCR é amplamente utilizada como um marcador não específico de inflamação, pois como proteína de fase aguda, seus níveis aumentam na maior parte das condições clínicas associadas à resposta inflamatória (Sierra et al, 2004;Vicente e Beumier, 2013).…”