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Table 1.
Overview of clinical studies concerning overfeeding in critically ill children
Study
Design, Patients
Applied definition
overfeeding
% overfeeding Risk factors for overfeeding
Outcome
Taylor et al., Clin Nutr. 2003
Nutritional
support in critically ill children
Retrospective study in 95 children in
PICU ≥3 days
Median age 7.7 (range 1-18.6) years
Ratio caloric intake/
pREE (Schofield-
weight) >110%
18% (n=135)
patient days
Parenteral nutrition
Hulst et al., Nutrition. 2005
Adequate feeding
and the usefulness of the respiratory
quotient in critically ill children
Prospective study in 98
mechanically ventilated children,
median age
14.6 days (range 0-15.2 y)
Ratio caloric intake/
mREE >120%
69% patient days None identified
Oosterveld et al., Pediatr Crit Care Med.
2006
Energy expenditure and balance following
pediatric intensive care unit admission: a
longitudinal study of critically ill children
Observational study in 46 children,
median age 4 (IQR 0-18) years
Ratio caloric intake/
mREE >110%
28% patient days Parenteral nutrition
De Neef et al., Clin Nutr. 2008
Nutritional goals, prescription and delivery in
a pediatric intensive care unit
Prospective study in 84 mechanically
ventilated children in PICU ≥3 days,
median age 4.7 (IQR 0.9-18.9) months
Ratio caloric intake/
pREE (WHO)>110%
26.5% patient days None identified
Mehta et al., Pediatr Crit Care Med. 2011
Energy imbalance and the risk of overfeeding
in critically ill children
Prospective study in 33
mechanically ventilated children,
median age 2 (range 0.1-25.8) years
Ratio caloric intake/
mREE >120%
83% (n=24)
children
Age < 1 year
Kyle et al., J Acad Nutr Diet. 2012
Nutrition support in critically ill children:
underdelivery of energy and protein
compared with current recommendations
Retrospective study in 240 children in
PICU >2 days
Ratio caloric intake/
pREE (Schofield-
weight) >110%
30% (n=344)
patient days
None identified
Dokken et al., JPEN J Parenter Enteral Nutr. 2015
Indirect calorimetry reveals that better
monitoring of nutrition therapy in pediatric
intensive care is needed
Prospective study in 30 mechanically
ventilated children, median age
15.5 (range 3-168) months
Ratio caloric intake/
mREE >120%
60.5% (n=63)
patient days
None identified
de Betue et al. Clin Nutr. 2015
Achieving energy goals at day 4 after
admission in critically ill children; predictive
for outcome?
Prospective study in 325 children at
day 4 after admission, median age
0.14 (range 0-18) years
Ratio caloric intake/
pREE (Schofield-
weight) >120%
74% of children
on PN and EN
combined (n=240)
43% of children
only on EN (n=140)
Younger children,
Malnourishment
Multivariate analysis: being overfed not associated
with change in no. of days until discharged
alive, no. of days on the ventilator, no. of days on
antibiotics, no. of new infections or site of infection
IQR = Interquartile Range, PICU = Pediatric Intensive Care Unit, mREE = measured Resting Energy Expenditure, pREE = predicted Resting Energy Expenditure, WHO =World
Health Organization, EN = Enteral Nutrition, PN = Parenteral Nutrition