Weisgerber Michael C, Lye Patricia S, Nugent Melodee, Li Shun-Hwa, De Fouw Kari, Gedeit Rainer, Simpson Pippa, Gorelick Marc H
Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Hosp Pediatr. 2013 Jan;3(1):24-30. doi: 10.1542/hpeds.2012-0032.
Poor oral intake is a common presenting symptom among infants hospitalized with bronchiolitis. The prevalence, degree, and duration of iminished caloric intake in these infants have not been studied. Our goal was to determine the daily caloric intake among infants admitted with bronchiolitis and to evaluate the relationship between early hospital caloric intake and length of stay (LOS).
We conducted a retrospective chart review of infants aged <1 year admitted to Children's Hospital of Wisconsin with bronchiolitis who were placed in the bronchiolitis treatment protocol during the 2004-2005 season. Patient-, disease-, respiratory-, and nutrition-specific data were abstracted.
A total of 273 patients with bronchiolitis were admitted between November 1, 2004, and April 15, 2005; placed on the bronchiolitis protocol; and included in the study. Median caloric intake was diminished on day 1 (53 kcal/kg per day) and day 2 (64 kcal/kg per day). Caloric intake was slower to normalize in infants with progressively longer LOS, and a slower rate of increase from day 1 to day 2 was significantly correlated with longer LOS (r= -0.18; P= .002). Subgroup analysis revealed significant correlations between hospital day 2 caloric intake and LOS in formula-fed infants, breastfed infants, infants aged <183 days, and infants aged > or =183 days.
Caloric intake was diminished in the early course of hospitalization for infants who had bronchiolitis and slowest to normalize in infants with the longest LOS. Interventions aimed at decreasing LOS among infants admitted with bronchiolitis should consider the potential significance of nutrition for severely affected infants with this condition.
经口摄入量低是住院治疗的毛细支气管炎婴儿常见的症状。这些婴儿热量摄入减少的发生率、程度和持续时间尚未得到研究。我们的目标是确定毛细支气管炎住院婴儿的每日热量摄入量，并评估早期住院热量摄入与住院时间（LOS）之间的关系。
我们对2004 - 2005年期间入住威斯康星儿童医院并采用毛细支气管炎治疗方案的1岁以下毛细支气管炎婴儿进行了回顾性病历审查。提取了患者、疾病、呼吸和营养方面的特定数据。
2004年11月1日至2005年4月15日期间，共有273例毛细支气管炎患者入院；采用了毛细支气管炎治疗方案；并纳入了本研究。第1天（每天53千卡/千克）和第2天（每天64千卡/千克）的热量摄入中位数减少。住院时间越长的婴儿热量摄入恢复正常的速度越慢，从第1天到第2天的热量摄入增加速度较慢与住院时间较长显著相关（r = -0.18；P = 0.002）。亚组分析显示，在配方奶喂养婴儿、母乳喂养婴儿、年龄小于183天的婴儿和年龄大于或等于183天的婴儿中，第2天的热量摄入与住院时间之间存在显著相关性。
毛细支气管炎婴儿在住院早期热量摄入减少，住院时间最长的婴儿热量摄入恢复正常的速度最慢。旨在缩短毛细支气管炎住院婴儿住院时间的干预措施应考虑营养对患有这种疾病的严重受影响婴儿的潜在重要性。
