Nutrition protocols improve caloric adequacy in critically Ill children: a systematic review and…

Systematic reviewFrontiers in pediatrics· 2026

Nutrition protocols improve caloric adequacy in critically Ill children: a systematic review and meta-analysis.

Yan Wang, Jia Wang, Xiao Sun … Nida Naeem

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Pediatric Critical & Emergency CareSystematic reviewClinical practiceQ1IF 2.2

Structured nutrition protocols associated with 21.98% higher caloric adequacy in critically ill children

Nutrition protocols improve caloric adequacy in critically Ill children: a systematic review and meta-analysis.

Yan Wang … Nida Naeem

Frontiers in pediatrics · 2026 · Q1 in Pediatrics

Background

Malnutrition is common among critically ill children admitted to the Pediatric Intensive Care Unit (Pediatric Intensive Care Unit).

Methods

We searched through PubMed, Embase, the Cochrane Library, and Web of Science from January 2015 to March 2026.

n = 1,992 children

Results

protocols delivered meaningfully more of children's calorie targets

Nurse-led

19.16%

Non-nurse-led

23.95%

More results

Both nurse-led (MD +19.16%) and non-nurse-led protocols (MD +23.95%) improved delivery without a significant between-group difference ( p = 0.51).

Study design was the dominant heterogeneity driver and explained 93.6% of between-study variance.

The pooled estimate was robust across all sensitivity analyses, and trim-and-fill imputed zero missing studies.

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Conclusion · 1 of 2

Structured nutritional protocols meaningfully improve caloric adequacy in critically ill children, regardless of whether nurses lead their implementation.

Conclusion · 2 of 2

These findings support the wider adoption of protocolized feeding as a standard of care in PICUs globally.

Nutrition protocols improve caloric adequacy in critically Ill children: a systematic review and meta-analysis.

Nutrition protocols improve caloric adequacy in critically Ill children: a systematic review and meta-analysis.

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