En fase aguda, el catabolismo reduce gasto energético; aporte >70% genera sobrealimentación con sustratos no utilizados (Mehta et al., 2011). En fase de recuperación, hipermetabolismo requiere incremento calórico progresivo, monitorizado por calorimetría indirecta (Veldscholte et al., 2020).
Proteína mantiene balance nitrogenado (1.5-2.5 g/kg/día), reduce pérdida muscular y mortalidad; calorías excesivas inhiben autofagia (Tume et al., 2020).
Riesgos incluyen hiperglucemia, resistencia insulínica, disfunción hepática y aumento de infecciones (Briassoulis et al., 2024).
En caso observado, niño con sepsis recibe 130% gasto en fase aguda, induce hiperglucemia y ventilación prolongada; ajuste a 60% con proteína priorizada resuelve en 48 horas (Wang et al., 2025).
Referencias
Briassoulis, G., Ilia, S., & Briassouli, E. (2024). Personalized nutrition in the pediatric ICU: Steering the shift from acute stress to metabolic recovery and rehabilitation. Nutrients, 16(20), 3523. https://doi.org/10.3390/nu16203523
Mehta, N. M., Bechard, L. J., Dolan, M., Ariagno, K., Jiang, H., & Duggan, C. (2011). Energy imbalance and the risk of overfeeding in critically ill children. Pediatric Critical Care Medicine, 12(4), 398–405. https://doi.org/10.1097/PCC.0b013e3181fe279c
Tume, L. N., Valla, F. V., Joosten, K., Jotterand Chaparro, C., Latten, L., Marino, L. V., Macleod, I., Moullet, C., Pathan, N., Rooze, S., van Rosmalen, J., & Verbruggen, S. C. A. T. (2020). Nutritional support for children during critical illness: European Society of Pediatric and Neonatal Intensive Care (ESPNIC) metabolism, endocrine and nutrition section position statement and clinical recommendations. Intensive Care Medicine, 46(3), 411–425. https://doi.org/10.1007/s00134-019-05922-5
Veldscholte, K., Joosten, K., & Jotterand Chaparro, C. (2020). Energy expenditure in critically ill children. Pediatric Medicine, 3, 17. https://doi.org/10.21037/pm-20-47
Wang, Y., Li, Y., Li, N., Li, Y., Li, H., & Zhang, D. (2025). Protective nutrition strategy in the acute phase of critical illness: Why, what and how to protect. Frontiers in Nutrition, 12, 1555311. https://doi.org/10.3389/fnut.2025.15553111,5s
Proteína mantiene balance nitrogenado (1.5-2.5 g/kg/día), reduce pérdida muscular y mortalidad; calorías excesivas inhiben autofagia (Tume et al., 2020).
Riesgos incluyen hiperglucemia, resistencia insulínica, disfunción hepática y aumento de infecciones (Briassoulis et al., 2024).
En caso observado, niño con sepsis recibe 130% gasto en fase aguda, induce hiperglucemia y ventilación prolongada; ajuste a 60% con proteína priorizada resuelve en 48 horas (Wang et al., 2025).
Referencias
Briassoulis, G., Ilia, S., & Briassouli, E. (2024). Personalized nutrition in the pediatric ICU: Steering the shift from acute stress to metabolic recovery and rehabilitation. Nutrients, 16(20), 3523. https://doi.org/10.3390/nu16203523
Mehta, N. M., Bechard, L. J., Dolan, M., Ariagno, K., Jiang, H., & Duggan, C. (2011). Energy imbalance and the risk of overfeeding in critically ill children. Pediatric Critical Care Medicine, 12(4), 398–405. https://doi.org/10.1097/PCC.0b013e3181fe279c
Tume, L. N., Valla, F. V., Joosten, K., Jotterand Chaparro, C., Latten, L., Marino, L. V., Macleod, I., Moullet, C., Pathan, N., Rooze, S., van Rosmalen, J., & Verbruggen, S. C. A. T. (2020). Nutritional support for children during critical illness: European Society of Pediatric and Neonatal Intensive Care (ESPNIC) metabolism, endocrine and nutrition section position statement and clinical recommendations. Intensive Care Medicine, 46(3), 411–425. https://doi.org/10.1007/s00134-019-05922-5
Veldscholte, K., Joosten, K., & Jotterand Chaparro, C. (2020). Energy expenditure in critically ill children. Pediatric Medicine, 3, 17. https://doi.org/10.21037/pm-20-47
Wang, Y., Li, Y., Li, N., Li, Y., Li, H., & Zhang, D. (2025). Protective nutrition strategy in the acute phase of critical illness: Why, what and how to protect. Frontiers in Nutrition, 12, 1555311. https://doi.org/10.3389/fnut.2025.15553111,5s