Nutrition is a key therapeutic intervention in the recovery of children from critical illness. Enteral nutrition timing, constituency, and amount has been linked to outcomes post ICU. Early and optimal enteral nutrition in critically ill children requires adequate gastrointestinal function, and yet gastrointestinal dysmotility and disruption of epithelial barrier integrity have been reported in ~50% of critically ill children.

Gastrointestinal function and enteral nutrition delivery are interweaved during critical illness. Clinicians assess gastrointestinal function to determine readiness to initiate nutrition and to monitor enteral nutrition tolerance and absorption. Furthermore, our approach to enteral nutrition, including the timing, amount, content and the route of delivery, may affect gastrointestinal function and enteral nutrition tolerance. The mechanisms underlying gastrointestinal dysfunction and the interplay between gastrointestinal function and enteral nutrition are key to optimizing nutrition provision for the critically ill child. The goal of this Research Topic is to address advances in our understanding of the relationship between enteral nutrition delivery and gastrointestinal health during pediatric critical illness.

This article collection welcomes novel clinical and translational research, and scoping reviews that address the following topics in the pediatric critically ill population including subspecialty units and special patient populations (e.g. cardiac, medical versus surgical, gastrointestinal, oncology):

-Mechanisms of gastrointestinal dysfunction (epithelial barrier and gastrointestinal motility) in pediatric critical illness.

-Role of the microbiome in gastrointestinal function in critical illness.

-Advances in defining or assessing for gastrointestinal dysfunction at the bedside (e.g. US, biomarkers).

-Research examining the effect of alternative approaches to enteral nutrition such as route (gastric vs. post-pyloric), mode of delivery (continuous vs. intermittent), macronutrient composition (protein ratio, hydrolyzed formulas) on clinical, nutritional or gastrointestinal function outcomes.

- Advances in therapeutic options for gastrointestinal dysfunction, eg. Prokinetics

We will also consider “perspective/ opinion” pieces by experienced practitioners sharing their clinical experience with specific difficult clinical scenarios associated with the topic of discussion.

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Frontiers in Pediatrics

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