Paediatric differences
The American Society for Parenteral and Enteral Nutrition statements from 1997 and 2002 indicated that no randomized controlled trials of nutritional support in children with critical illness had been found (ASPEN 2002; Klein 1997). The nutritional needs of children with critical illness may be different from adults in many ways: in terms of underlying metabolism and growth, underlying illness and co-morbidities, pre-existing energy reserves (particularly in young infants), and responses to critical illness. It would be ideal to have studies specific to children to guide nutritional support in critically ill children. For these reasons, a systematic review is needed to identify any randomized controlled trials of nutritional support during the first week of illness in critically ill children. Evidence is needed to provide clear guidelines for how and when to initiate feedings in children requiring intensive care. We did not include premature or low birth weight neonates as their care is in a neonatal intensive care unit and their needs are very likely to be different frominfants
and children during the first week of critical illness.