Nutritional supplementation in pediatric intensive care units (PICUs) remains a field with many unresolved gray areas, lacking detailed research [1]. While nutritional support is deemed a cornerstone in pediatric critical care, some view it merely as ancillary. In the treatment of pediatric critically ill patients, fluid overload significantly impacts poor prognosis [2]. However, the delivery of nutrients considered as part of intake fluid is given lower priority compared to essential treatments such as medications or transfusions within intake volume, making it challenging to ensure adequate nutritional delivery. This may be one of the reasons why malnutrition remains prevalent, despite significant changes in pediatric critical care nutrition brought about by guidelines from ASPEN and ESPEN [3,4].

Nutrition is vital for life, especially for growing children. Malnutrition correlates with poor outcomes, and adequate caloric and protein intake improves long-term results in critically ill patients [5,6]. Hence, nutrition should be recognized as a therapeutic component in pediatric critical care, and tailored nutritional therapy is necessary to treat patients with various ages and diagnoses.

For tailored nutritional support, it demands critical thinking skills, which in turn require a multidisciplinary approach comprising specialized physicians, pharmacists, dietitians, and nurses.

The Annals of Clinical Nutrition and Metabolism is expected to establish consensus on pediatric critical care nutrition and provide evidence through research, significantly contributing to the multidisciplinary approach to nutritional delivery in PICUs.