Preface

The provision of optimal nutrition to the critically ill child, to offset the catabolic effects of the illness or injury and to enhance clinical outcomes, is an important objective for healthcare providers. The last decade has seen a resurgence in interest in this area of critical care, with an increasing number of research publications and consensus documents. The field of critical care nutrition has evolved, and clear associations between bedside nutrient delivery and outcomes have been demonstrated. Nutrition delivery is no longer just supportive care, but it is now recognized as an important therapy with nutrients that can modulate disease. Despite the enthusiasm and the explosion in research on the subject, there are many unanswered questions, and the quest for best practices remains elusive, especially in the pediatric intensive care unit (PICU). The individual practitioner—the trainee, the intensivist, the dietitian, the nurse—is left with a number of practical questions on the nutritional management of the individual child in the PICU.

We are delighted to present the first edition of Pediatric Critical Care Nutrition, a comprehensive textbook that addresses nutrition therapy for the critically ill newborn infant and child. To our knowledge, this is the first and currently only available textbook on this subject. The book has been divided into three sections, with chapters that describe nutritional aspects of a variety of pediatric critical illnesses. The book includes contributions from some of the leading experts in this area from around the world. The authors represent a multidisciplinary group consisting of critical care physicians, critical care nurses, gastroenterologists, pediatric surgeons, dietitians, and pharmacists. Each author sees the critically ill child from a distinct vantage point based on their practice area and hence, provides a unique perspective. The chapters represent collaborations between authors from different institutions, regions, and specialties. We aimed for a book that is eminently readable, whether one chooses to read it from cover to cover or to focus on individual chapters. We have emphasized certain themes throughout this book, such as our belief in enteral nutrition as the best mode of nutrient delivery, screening for nutritional status, indirect calorimetry to accurately determine energy requirements, the role of a multidisciplinary team of nutrition champions, and the importance of studying the impact of nutrition therapy on clinical outcomes.

We believe that nutrition therapy has been ignored in the PICU, and it is time to emphasize its importance during critical illness and realize its potential impact on clinical outcomes. We hope that this book summarizes the important work done by several champions over the past decade, and that it will kindle an interest in researching the vast expanses of PICU nutrition knowledge that need to be explored. It is our sincere belief that by adopting and implementing the best practices in this book, hospitals and healthcare professionals can achieve safer care and make meaningful and long-lasting improvements to bedside nutrient delivery, with the ultimate aim of improving outcomes in the vulnerable child in the PICU. We also hope that this book will serve to encourage future research in this field so that we can continue to build on the strides that have already been achieved.

Finally, we would like to express our deep gratitude to all our authors for their time and tremendous contributions. Without them, this book would not have been possible. They are the true leaders and pioneers in our field, and we will continue to look to them for collaboration and guidance in the future.