Pediatric anesthesia & critical care
A negative fluid balance may compromise nutritional delivery in mechanically ventilated critically ill children: a retrospective observational cohort study
Main findingResult — go to the resultReduction in delivered energy 50%Authors' conclusion
During early paediatric critical illness, fluid balance and nutritional delivery follow interdependent trajectories. Strategies aimed at achieving negative fluid balance are associated with substantially reduced energy delivery, independent of illness severity.
Study context
- Population
- Mechanically ventilated children (0–18 years) admitted ≥ 24 h to a tertiary PICU, 2019–2024, who received furosemidemedian age 42 months
- Participants
- 511 participants
- Exposure
- Negative vs neutral/positive cumulative fluid balance
- Outcome
- Cumulative nutritional delivery (% of predicted energy expenditure)
- Follow-up
- ICU discharge or day 7
Methodological detailsobservational, single-centre
- Observational
- Single-centre
Main finding
As reported in the abstract
Reduction in delivered energy
50%
P = 0.002
Observational data: associations, not effects.
Further findings
Nutritional support over time
- Receiving nutrition by 72 h
- > 75%
- Receiving nutrition by day 7
- > 90%
- Enteral feeding predominated
Fluid balance trajectory
- Initially positive, toward neutral and negative after ≈72 h; as cumulative fluid balance declined, cumulative nutritional delivery increased
Other predictors of nutritional delivery (adjusted)
- Younger age associated with lower nutritional delivery; longer ICU stay associated with modest increases
Original publication
A negative fluid balance may compromise nutritional delivery in mechanically ventilated critically ill children: a retrospective observational cohort study. Crit Care. Published 19 March 2026. doi:10.
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