ICU Pathway for the Evaluation/Treatment of Infants > 28 Days
and Children with Severe Sepsis/Septic Shock
Nutrition – First 24 Hours
Within first 24 hours of admission
Order nutrition consult
Head circumference for children <2 yrs old
- Serum Prealbumin
- C Reactive Protein
- Begin dextrose containing isotonic solution at a maintenance fluid rate.
- Avoid hypoglycemia (blood glucose less than 60 mg/dl).
- Maintain serum glucose 80-180 mg/dl.
- Suggested target for glucose infusion rate (GIR) to guide intravenous (IV) glucose concentration
|Infants - Preschool
|School Age and Adolescent
||Up to 16 mg/kg/min
- Consider D10 fluids if D5 unable to provide glucose requirements for age.
- If serum glucose > 180 mg/dl, consider insulin therapy by continuous infusion to control hyperglycemia
- Develop a nutrition plan with registered dietician (RD)
- Correct electrolyte abnormalities as clinically indicated
Nutrition – References