Although children represent only 1% of all patients with malignant neoplasms, up to 38% of them require at least one PICU admission during the course of their illness. Children with cancer account for 4.2% of all PICU admissions. Metabolic response to stress in critically ill oncology and bone marrow transplant children results to inflammation, lipid oxidation, skeletal muscle breakdown and loss of body protein.
Malnutrition significantly affects tolerance to chemotherapy, increased susceptibility to infections and reduced survival. The ideal route of nutritional therapy is enteral. Parenteral route is reserved for patients where GI is compromised. Glutamine-containing parenteral or enteral nutrition is not recommended.