To quantify the pooled effect of structured nutritional protocols on caloric adequacy specifically in critically ill pediatric patients in the PICU.
Approach:
Literature Search: Systematic search across PubMed, Embase, the Cochrane Library, and Web of Science from January 2015 to March 2026, restricted to studies published in English.
Key Findings:
Nine studies enrolling 1,992 children across six countries were included.
Nutritional protocols were associated with a pooled mean difference of +21.98% in caloric adequacy (p < 0.001).
Both nurse-led and non-nurse-led protocols improved caloric delivery without significant difference between groups (p = 0.51).
Study design was the main driver of heterogeneity, explaining 93.6% of variance.
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