Association between nutritional status and outcomes in critically-ill pediatric patients – a systematic review

To systematically review the evidence about the impact of nutritional status in critically-ill pediatric patients on the following outcomes during hospitalization in pediatric intensive care units: length of hospital stay, need for mechanical ventilation, and mortality. The search was carried out in the following databases: Lilacs (Latin American and Caribbean Health Sciences), MEDLINE (National Library of Medicine United States) and Embase (Elsevier Database). No filters were selected. A total of seven relevant articles about the subject were included. The publication period was between 1982 and 2012. All articles assessed the nutritional status of patients on admission at pediatric intensive care units and correlated it to at least one assessed outcome. A methodological quality questionnaire created by the authors was applied, which was based on some references and the researchers’ experience. All included studies met the quality criteria, but only four met all the items. The studies included in this review suggest that nutritional depletion is associated with worse outcomes in pediatric intensive care units. However, studies are scarce and those existing show no methodological homogeneity, especially regarding nutritional status assessment and classification methods. Contemporary and well-designed studies are needed in order to properly assess the association between children's nutritional status and its impact on outcomes of these patients. Revisar, de forma sistemática, as evidências acerca do impacto do estado nutricional de pacientes pediátricos críticos sobre os seguintes desfechos durante a internação em Unidades de Terapia Intensiva Pediátrica: Tempo de internação, necessidade de ventilação mecânica e mortalidade. A busca foi realizada nas seguintes bases de dados: Lilacs (Literatura Latino-Americana e do Caribe em Ciências da Saúde), Medline(National Library of Medicine Estados Unidos), e Embase (Elsevier Base de Dados). Não houve seleção de filtros. Foram incluídos sete artigos relevantes sobre o tema. O período de publicação variou entre 1982 e 2012. Todos avaliam o estado nutricional de pacientes no momento da internação em Terapia Intensiva Pediátrica e relacionam com pelo menos um desfecho estudado. Foi aplicado um questionário de qualidade metodológica criado pelos autores. Ele foi baseado em algumas referências e experiência dos pesquisadores. Todos os estudos incluídos alcançaram os critérios de qualidade, porém apenas quatro, atenderam