Riesgo de diabetes mellitus tipo II en personas de las parroquias San Miguel y Javier Loyola, según el cuestionario Findrisk, periodo octubre 2024 - enero 2025

Abstract

Introduction: Nutritional support for pediatric patients in Pediatric Intensive Care Units is an essential pillar of recovery and complication reduction. In the past, early nutritional support was recommended to prevent metabolic deterioration; however, its benefits and risks have been questioned, highlighting the need for personalized strategies. Objective: To analyze the efficacy of nutritional support in children admitted to Pediatric Intensive Care Units through a systematic review of studies published between 2015 and 2025. Methodology: This is a qualitative study that included clinical trials on nutritional support in critically ill pediatric patients. Neonates, narrative reviews, and articles without relevant clinical data were excluded. The search was conducted in PubMed, Scopus, and the Cochrane Library. Risk of bias was assessed using the Cochrane Risk of Bias tool. Results: A total of 20 clinical trials were included, representing more than 5,200 pediatric patients. Early parenteral nutrition showed benefits in nutritional recovery and a slight reduction in mechanical ventilation, but demonstrated a higher risk of metabolic, hepatic, and infectious complications. In contrast, early enteral nutrition showed better clinical outcomes, a lower risk of infections, and a shorter PICU stay, although mild and transient gastrointestinal adverse events occurred. Discussion: The findings support prioritizing early enteral nutrition as the route of choice whenever feasible, while parenteral nutrition should be reserved for cases in which enteral nutrition is contraindicated or insufficient. Conclusions: The evidence favors early enteral nutrition as the first option, provided that it is tolerated. Keywords: nutritional support, Pediatric Intensive Care Unit, hospital malnutrition