With 13-17% prevalence rate of childhood obesity in Canada and the US, comorbidities are consequential. Micromanaging these comorbidities allows faster transit out of PICU. Underweight and obese children have significantly higher incidence of infections and mortality.
The presence of persistent inflammatory catabolic syndrome (PICS) leads to persistent inflammation, immune suppression, protein catabolism and poor nutritional status. The issue of sarcopenic obesity should likewise be addressed as this requires higher protein needs. The goal of nutritional provision is to strike a balance between maintaining lean muscle mass and nutrition.