Abstract
Following an admission to a paediatric intensive care unit (PICU), nutrition support should be introduced early to help prevent deleterious consequences of malnutrition (including micronutrient malnutrition). The pathophysiology of critical illness affects the metabolic response and subsequent nutritional needs which change during the course of critical illness requiring regular review and evaluation. The multi-disciplinary PICU team should include a dedicated dietitian with specialist nutritional knowledge and competencies. These will be required to complete a detailed nutritional assessment in critically ill children throughout their admission. An ABCDE global and evaluative approach may be used, including the assessment of: Anthropometry (A), Biochemistry (B), Clinical considerations (C), Dietary (D) and Evaluation (E). In order to develop nutritional guidelines integrating these five aspects, the involvement of a motivated interprofessional team including a physician, pharmacist, dietitian and nurses is necessary. This chapter will discuss and review the available data on considerations for nutrition support of critically ill children, using the ABCDE approach to nutrition support. We will also clarify the roles and responsibilities of clinicians, more specifically dietitians, regarding these aspects during the different stages of PICU stay.