Protein Requirements of the Critically Ill Pediatric Patient

Jorge A. Coss-Bu, Jill Hamilton-Reeves, Jayshil J. Patel, Claudia R. Morris, Ryan T Hurt

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

This article includes a review of protein needs in children during health and illness, as well as a detailed discussion of protein metabolism, including nitrogen balance during critical illness, and assessment and prescription/delivery of protein to critically ill children. The determination of protein requirements in children has been difficult and challenging. The protein needs in healthy children should be based on the amount needed to ensure adequate growth during infancy and childhood. Compared with adults, children require a continuous supply of nutrients to maintain growth. The protein requirement is expressed in average requirements and dietary reference intake, which represents values that cover the needs of 97.5% of the population. Critically ill children have an increased protein turnover due to an increase in whole-body protein synthesis and breakdown with protein degradation leading to loss of lean body mass (LBM) and development of growth failure, malnutrition, and worse clinical outcomes. The results of protein balance studies in critically ill children indicate higher protein needs, with infants and younger children requiring higher intakes per body weight compared with older children. Monitoring the side effects of increased protein intake should be performed. Recent studies found a survival benefit in critically ill children who received a higher percentage of prescribed energy and protein goal by the enteral route. Future randomized studies should evaluate the effect of protein dosing in different age groups on patient outcomes, including LBM, muscle structure and function, duration of mechanical ventilation, intensive care unit and hospital length of stay, and mortality.

Original languageEnglish (US)
Pages (from-to)128S-141S
JournalNutrition in Clinical Practice
Volume32
Issue number1_suppl
DOIs
StatePublished - Apr 1 2017

Fingerprint

Critical Illness
Pediatrics
Proteins
Length of Stay
Recommended Dietary Allowances
Growth
Hospital Mortality
Growth and Development
Artificial Respiration
Malnutrition
Proteolysis
Small Intestine
Prescriptions
Intensive Care Units
Nitrogen
Age Groups
Body Weight
Food

Keywords

  • catabolism
  • child
  • critical illness
  • intensive care
  • nitrogen balance
  • pediatrics
  • protein
  • protein balance

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

Cite this

Coss-Bu, J. A., Hamilton-Reeves, J., Patel, J. J., Morris, C. R., & Hurt, R. T. (2017). Protein Requirements of the Critically Ill Pediatric Patient. Nutrition in Clinical Practice, 32(1_suppl), 128S-141S. https://doi.org/10.1177/0884533617693592

Protein Requirements of the Critically Ill Pediatric Patient. / Coss-Bu, Jorge A.; Hamilton-Reeves, Jill; Patel, Jayshil J.; Morris, Claudia R.; Hurt, Ryan T.

In: Nutrition in Clinical Practice, Vol. 32, No. 1_suppl, 01.04.2017, p. 128S-141S.

Research output: Contribution to journalArticle

Coss-Bu, JA, Hamilton-Reeves, J, Patel, JJ, Morris, CR & Hurt, RT 2017, 'Protein Requirements of the Critically Ill Pediatric Patient', Nutrition in Clinical Practice, vol. 32, no. 1_suppl, pp. 128S-141S. https://doi.org/10.1177/0884533617693592
Coss-Bu, Jorge A. ; Hamilton-Reeves, Jill ; Patel, Jayshil J. ; Morris, Claudia R. ; Hurt, Ryan T. / Protein Requirements of the Critically Ill Pediatric Patient. In: Nutrition in Clinical Practice. 2017 ; Vol. 32, No. 1_suppl. pp. 128S-141S.
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