Department of Nutrition Services, Alberta Children's Hospital, Alberta Health Services, Calgary, AB T3B 6A8, Canada.
Appl Physiol Nutr Metab. 2012 Aug;37(4):715-23. doi: 10.1139/h2012-050. Epub 2012 Jun 5.
Children with severe cerebral palsy (CP) often have lower mineral intakes than healthy children. It is unknown if their lower nutrient intakes are adequate to meet their needs. The objective of this study was to examine the sodium, potassium, phosphate, and fluid status of primarily tube-fed nonambulatory children with severe CP. The design consisted of a cross-sectional exploratory study and a clinical trial of sodium supplementation. Nutritional status was determined among primarily tube-fed children (aged 2 to 17 years) with CP based on blood and urine samples, anthropometry, and 3-day food records. Mineral and fluid status was evaluated by a nephrologist blind to nutrient intakes. Twenty children supplied food records, blood samples, and anthropometric measurements, and 16 supplied urine samples. Six (37.5%) of those who provided urine samples were considered possibly dehydrated, as urine osmolality was >600 mmol·kg(-1). Six (60%) of the 10 children with satisfactory fluid status (low urine osmolality) were considered to have a possible dietary sodium deficiency based on a very low urine sodium concentration (<20 mmol·L(-1)). Those considered to have a possible dietary sodium deficiency had a significantly lower sodium intake (48% ± 15% Adequate Intake (AI)) compared with those considered sodium sufficient (73% ± 20% AI) (p = 0.031). One child was considered possibly phosphorus deficient, but none was assessed as likely potassium deficient. The conclusion was that sodium deficiencies were likely prevalent among the children. The findings from this small observational study suggest that sodium intakes for tube-fed children with CP should be maintained near the AI for their age. Hydration status of children receiving hypercaloric formulas should be monitored.
患有严重脑瘫（CP）的儿童通常摄入的矿物质低于健康儿童。目前尚不清楚他们较低的营养素摄入量是否足以满足其需求。本研究的目的是检查主要通过管饲喂养的严重 CP 非活动性儿童的钠、钾、磷酸盐和液体状态。设计包括横断面探索性研究和钠补充的临床试验。根据血液和尿液样本、人体测量学和 3 天食物记录，确定主要通过管饲喂养（年龄 2 至 17 岁）的 CP 儿童的营养状况。肾脏病学家在不知道营养素摄入量的情况下评估矿物质和液体状态。20 名儿童提供了食物记录、血液样本和人体测量学测量值，16 名儿童提供了尿液样本。在提供尿液样本的 16 名儿童中，有 6 名（37.5%）被认为可能脱水，因为尿渗透压>600mmol·kg(-1)。在具有满意液体状态（低尿渗透压）的 10 名儿童中，有 6 名（60%）被认为可能存在膳食钠缺乏，因为尿钠浓度非常低（<20mmol·L(-1)）。被认为可能存在膳食钠缺乏的儿童的钠摄入量明显较低（48%±15%适宜摄入量（AI）），而被认为钠充足的儿童的钠摄入量为 73%±20% AI（p=0.031）。有 1 名儿童被认为可能存在磷缺乏，但没有人被认为可能存在钾缺乏。结论是，钠缺乏症可能在这些儿童中普遍存在。这项小型观察性研究的结果表明，CP 管饲喂养儿童的钠摄入量应接近其年龄的 AI。应监测接受高热卡配方的儿童的液体状态。
