Nutritional Assessment of Critically Ill Children: the search for practical tools

Critically ill children are at risk of deteriorating nutritional status when admitted to an intensive care unit. This may lead to malnutrition, which is associated with increased morbidity and mortality. While adequate feeding is essential for complete recovery and normal functional outcome of the growing child, caregivers on admission tend to focus on the primary medical problem. In order to provide good nutritional care it seems essential to fully assess the child’s nutritional status and needs. Various methods are available, and it is the child’s age, clinical presentation, and illness severity that determine which of them is most suitable as individual approach. This thesis describes the prevalence of malnutrition in critically ill children and investigates the applicability and usefulness of the available assessment methods for identifying children with poor initial nutritional status or at risk of developing malnutrition. We focused on the feasibility of routine use in the pediatric ICU setting. In this thesis we analyzed data obtained from a cohort of children receiving intensive care in the Erasmus MC-Sophia Children’s Hospital during the year 2001. This cohort consisted of preterm neonates, term neonates and older children aged 30 days-16 years.

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