PedsCrit Nutrition in Critical Illness with Dr. Enid Martinez, 1/2
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Dec 1, 2025 Dr. Enid Martinez, a Senior Associate in pediatric critical care at Boston Children's Hospital, shares her expertise on nutrition's critical role in the recovery of severely ill children. She discusses alarming rates of malnutrition in the PICU and the metabolic disruptions caused by critical illness. Listeners learn about early feeding goals and the importance of accurate energy assessments using indirect calorimetry. Enid highlights the need for multidisciplinary nutrition teams and warns against the dangers of overfeeding, which can exacerbate respiratory issues.
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Nutrition Is Part Of Recovery
- Nutrition is integral to recovery after ABCs are addressed and affects ventilator liberation and rehabilitation.
- Dr. Enid Martinez emphasizes nutrition as a core part of helping a child's body recover from critical illness.
Malnutrition Is Common And Modifiable
- About 20% of pediatric ICU patients present undernourished and another ~20% are obese, meaning ~40% have nutrition-related problems.
- Up to 50% of children admitted can develop malnutrition while under ICU care, a highly modifiable problem.
Critical Illness Causes Maladaptive Catabolism
- Critical illness triggers catabolism with inefficient glucose use, insulin resistance, and protein breakdown damaging muscle needed for recovery.
- Dr. Martinez calls this a maladaptive metabolic state that often requires stopping the triggering insult for true recovery.