Children are in a steady state of growth, development, and organ maturation which make their responses to injury / illness unpredictable.

Energy requirements

  • Infants require ~4 times more energy than adults
  • Cannot be in anabolic and catabolic states at same time
  • Needs are based on estimates of basal requirements adjusted for stress & activity

Protein requirements

  • Markedly elevated during illness
  • Pts progress through period of negative nitrogen balance when ill
  • Exogenous protein may maximize protein synthesis and decrease net protein loss
  • Important to provide adequate protein early in illness to prevent wasting

Carbohydrate requirements

  • Exogenous carbs will reduce need for gluconeogenesis and spares breakdown of proteins
  • Glucose oxidation rates may be elevated by stress, resulting in hyperglycemia
  • In volume restricted pts, may need higher glucose infusions to provide basal metabolic requirements

Fat requirements

  • Require minimum of 0.5 gm/kg/d to meet essential fatty acid needs
Age Protein g/kg/day Normal Protein g/kg/day Stress Energy Kcal/kg/day Critical Illness Energy Kcal/kg/day Growth
0 - 6 mo 2.2 2.5 - 3.0 85 - 95 100 - 110
7mo - 1 yr 1.2 2.0 - 2.5 80 - 90 100
1 - 3 yr 1.1 1.8 - 2.25 80 - 90 100
4- 8 yr 1.0 1.5 - 2.0 70 - 80 90
9 - 13 yr 1.0 1.5 - 2.0 55 - 70 70
14 - 18 yr 0.9 1.5 - 2.0 45 - 55 45 - 55