Silva Fernanda Marchetto da, Bermudes Ana Carolina Gouvea, Maneschy Ivie Reis, Zanatta Graziela de Araújo Costa, Feferbaum Rubens, Carvalho Werther Brunow de, Tannuri Uenis, Delgado Artur Figueiredo
Ambulatório de Especialidades, Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil; Departamento de Pediatria, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
Rev Assoc Med Bras (1992). 2013 Nov-Dec;59(6):563-70. doi: 10.1016/j.ramb.2013.06.013. Epub 2013 Nov 4.
To assess the impact of early introduction of enteral nutrition therapy in reducing morbidity and mortality in pediatric intensive care unit.
Search in the literature of the last 10 years, in English and the target population of individuals aged 1 month to 18 years admitted to pediatric intensive care units in the databases PubMed, Lilacs and Embase using the keywords: Critical Care, Nutritional Support and Nutrition Disorders or Malnutrition.
Despite advances in the quality of clinical care, the prevalence of malnutrition in hospitalized children remains unchanged in the last 20 years (15-30%) and has implications for the time of admission, course of illness and morbidity. Malnutrition is common and is often poorly recognized and therefore, untreated. Nutritional therapy is an essential part in the treatment of pediatric patients who have severely ill hypercatabolic state protein, which can be minimized with an effective nutritional treatment plan. In this study, we reviewed publications which have shown that there is still a paucity of randomized and controlled studies with good statistical treatment in relation to enteral nutritional therapy with outcomes related to morbidity and mortality. The current guidelines for nutritional therapy in these patients are largely based on expert opinion and data extrapolated from adult studies and studies in healthy children.
The scientific evidence on the use of enteral nutrition therapy in improving the development of critically ill pediatric patients is still scarce and further studies are needed focusing on it, and better guidelines must be formulated.
评估早期引入肠内营养治疗对降低儿科重症监护病房发病率和死亡率的影响。
在过去10年的文献中进行检索，使用关键词“重症监护”“营养支持”“营养障碍或营养不良”，在PubMed、Lilacs和Embase数据库中检索1个月至18岁入住儿科重症监护病房的个体的英文文献。
尽管临床护理质量有所提高，但住院儿童营养不良的患病率在过去20年中仍未改变（15%-30%），且对入院时间、病程和发病率有影响。营养不良很常见，往往未得到充分认识，因此未得到治疗。营养治疗是患有严重疾病的高分解代谢状态蛋白质的儿科患者治疗的重要组成部分，有效的营养治疗计划可将其影响降至最低。在本研究中，我们回顾了一些出版物，这些出版物表明，关于肠内营养治疗与发病率和死亡率相关结果的随机对照研究仍然很少，且缺乏良好的统计学处理。目前这些患者的营养治疗指南很大程度上基于专家意见以及从成人研究和健康儿童研究中推断出的数据。
关于使用肠内营养治疗改善危重症儿科患者病情发展的科学证据仍然不足，需要进一步开展相关研究，并制定更好的指南。
