The aim of the study to evaluate the effectiveness and patient's outcome after implementing enteral nutrition algorithm designed to achieve optimal enteral nutrition delivery in the pediatric intensive care unit and to evaluate the effect of implementing this protocol on critically ill patient's individual's outcome.
Critically ill infants and children admitted to the Pediatric Intensive Care Units.
Age range from 1 month to 16 years (specifically males up to 14 years and females up to 16 years).
Patients who are discharged or died within 24 hours of admission.
Patients with acute pancreatitis.
Patients with esophageal perforation.
Patients with a known metabolic disorder.
Sequential
Stepwise Enteral Nutritional Algorithm
Other interventionA standardized, stepwise protocol for the initiation, advancement, and maintenance of enteral nutrition in critically ill children. It includes specific guidelines for caloric targets, managing feeding intolerance (vomiting, diarrhea, distention), and standardized fasting times for procedures to minimize interruptions.
Time to reach target energy goals
The duration (measured in days) required for the patient to achieve 100% of their calculated daily caloric target via enteral nutrition. Caloric targets are determined using FAO/WHO/UNU estimated energy requirements or the Schofield equation for sedated/ventilated patients.
Number of enteral nutrition interruptions
The total count of episodes where enteral feeding was temporarily or permanently stopped. An interruption is defined as the cessation of feeding for reasons such as hemodynamic instability, medical procedures, or aspiration risk.
Length of Pediatric Intensive Care Unit stay
The total duration (in days) a patient remains in the PICU from admission to discharge. This measure is compared between the pre-implementation and post-implementation groups to evaluate if the stepwise nutritional algorithm reduces the length of stay.
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