The goal of this observational study is to determine the micronutrient levels in patients in the Pediatric Palliative Care Clinic. The main question it aims to answer are:

• What is the frequency of micronutrient deficiencies in pediatric palliative care patients?

Palliative care is an important health service provided with a multidisciplinary approach to improve the quality of life of children with progressive and life-threatening diseases and to manage symptoms effectively. This service aims to provide children with a good life experience by meeting the physical, psychological, social and spiritual needs of patients and their families.

Micronutrients contain important nutritional components such as vitamins, minerals and other nutrients that are essential for maintaining normal functions of the body. Micronutrient deficiencies affect at least half of children under five years of age. In a study conducted in pediatric oncology patients, micronutrient deficiency was shown to have a frequency of 74%, and selenium deficiency in particular negatively affected clinical outcomes. Contrary to recommended nutrient intakes (RNI) and expert opinion for healthy children, evidence-based recommendations for micronutrient requirements in critically ill children are not available. However, in pediatric palliative care, if the nutritional history indicates inadequate nutritional intake and/or growth indicates malnutrition, nutritional deficiencies that may have systemic effects, such as iron and vitamin B12 deficiency, need to be investigated.

This article aims to fill the gap in the literature by determining the micronutrient levels of pediatric palliative care patients hospitalized in the Pediatric Palliative Care Clinic. The research aims to contribute to a better understanding of the nutritional needs of patients in pediatric palliative care and to direct treatment approaches more effectively.

Inclusion Criteria:

• Hospitalized in a pediatric palliative care service

Exclusion Criteria:

• Patients who are hospitalized without having chronic, complex, progressive or life-threatening diseases (for off-label reasons)

Our study will be carried out in the only pediatric palliative care center in Izmir that has been accepting patients since 2018. Our center is a clinic where palliative care patients (with chronic, complex, progressive or life-threatening diseases) between the ages of 1 month and 18 years who require hospitalization for various indications are managed with a multidisciplinary approach.