The effect of malnutrition on critically ill infants in the intensive care unit includes dysfunction of most organ systems, made worse by organ immaturity and reduced intrinsic energy stores. The current review focuses on the medical and surgical literature from the past 18 months, including select overview articles, studies on infant stress, metabolic indices, and the effect of nutrition on postoperative mortality in surgical infants. Gastrointestinal priming and early enteral feeding are receiving increased emphasis, and a number of studies on the composition and physiology of nutrition support have highlighted the small margin for error in the neonatal age group, focusing on several specific vital nutrients such as vitamin A, thiamine, iron, and intravenous lipids. Updates on safety, sepsis, and vascular access are also reviewed, as are the studies on the long-term effects and complications of nutritional support, including hepatobiliary function, gut mucosal barriers to bacterial translocation, and total parental nutrition-related bone disease.
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