Assessment of Nutritional Status of Critically Ill Children Admitted to Pediatric Intensive Care Units at Sohag University Hospitals

Nutrition is one of the important factors which affect morbidity and mortality in critically ill patients in pediatric intensive care units (PICU). Adequate and balanced nutrition is required not only to support physical growth and basic metabolic needs, but also to ensure proper organ function and sustain daily activities.

Nutritional status reflects the dynamic balance between nutrient availability, dietary intake, and the body's ability to absorb and utilize those nutrients in relation to an individual's specific needs.

Critical illness triggers significant metabolic and endocrine changes which are characterized by catabolism, insulin resistance, stress hyperglycemia and shifts in substrate utilization. These changes closely interact with disruptions in the autonomic and immune systems. Critically ill infants and children may have an increased metabolic need, which predisposes them to nutritional deterioration and malnutrition during illness.

The World Health Organization (WHO) defines malnutrition as " an acute or chronic nutritional status due to deficiency or excess energy, protein and micronutrient resulting in imbalance between nutrient intake and requirement that can negatively affect growth and development".

Malnutrition in critically ill patients is associated with decreased respiratory function, higher rate of nosocomial infections, secondary immunodeficiency, prolonged mechanical ventilation and prolonged hospitalization. It is also related to delayed wound healing process, impairment in gastrointestinal functions, thus increased morbidity and mortality.