Clinical and metabolic aspects of protein-energy malnutrition in patients in pediatric intensive care units

Inadequate quantitative and/or component nutrition of children remains an urgent problem worldwide. The General Assembly of the United Nations formulated the “Global Monitoring Framework for Nutrition”, as a result of which the level of acute nutritional deficiencies in the general child population should be reduced to 5% by 2025. A systematic analysis was conducted on the basis of scientific publications in the electronic databases PubMed, EMBASE, Cochrane Library, eLibrary.ru. The data obtained showed that in developed economies protein-energy deficiency is registered in 2.4–26% of patients admitted to medical inpatient facilities. Nutritional deficiency in pediatric patients is polyetiological and can influence the outcome of the disease. Critical conditions (trauma, severe infectious diseases and their complications, destructive pancreatitis, etc.) contribute a significant part to the etiologic structure of protein-energy deficiency in patients. Understanding the pathogenesis of protein-energy deficiency in patients in critical condition allows to optimally approach the organization and provision of care and, in particular, nutritional support. Analysis of the results of studies has shown that malnutrition in children in critical conditions causes a violation of all types of metabolism: carbohydrate, protein, fat, and vitamin metabolism. On the background of hypermetabolism there are changes in hormonal and immunologic status, shifts in water-electrolyte balance. A wide range of specialized products is presented for organizing both tube and oral nutrition in children who need nutritional support.