Bairdain Sigrid, Khan Faraz A, Fisher Jeremy, Zurakowski David, Ariagno Katelyn, Cauley Ryan P, Zalieckas Jill, Wilson Jay M, Jaksic Tom, Mehta Nilesh M
Department of Pediatric Surgery, Boston Children's Hospital, and Harvard Medical School, Boston, MA, United States.
Department of Pediatric Surgery, Boston Children's Hospital, and Harvard Medical School, Boston, MA, United States; Department of Anesthesiology, Perioperative & Pain Medicine, Boston Children's Hospital, and Harvard Medical School, Boston, MA, United States.
J Pediatr Surg. 2015 Jan;50(1):74-7. doi: 10.1016/j.jpedsurg.2014.10.003. Epub 2014 Oct 17.
Malnutrition is prevalent among congenital diaphragmatic hernia (CDH) survivors. We aimed to describe the nutritional status and factors that impact growth over the 12-months following discharge from the pediatric intensive care unit (PICU) in this cohort.
CDH survivors, who were discharged from the PICU from 2000 to 2010 with follow-up of at least 12months, were included. Nutritional intake, anthropometric, and clinical variables were recorded. Multivariable linear regression was used to determine factors associated with weight-for-age Z-scores (WAZ) at 12months.
Data from 110 infants, 67% male, 50% patch repair, were analyzed. Median (IQR) WAZ for the cohort was -1.4 (-2.4 to -0.3) at PICU discharge and -0.4 (-1.3 to 0.2) at 12-months. The percentage of infants with significant malnutrition (WAZ<-2) decreased from 26% to 8.5% (p<0.001). Patch repair (p=0.009), protein intake<2.3g/kg/day (p=0.014), and birth weight (BW)<2.5kg (p<0.001) were associated with lower WAZ at 12-months.
CDH survivors had a significantly improved nutritional status in the 12-months after PICU discharge. Patch repair, lower BW, and inadequate protein intake were significant predictors of lower WAZ at 12-months. A minimum protein intake in the PICU of 2.3g/kg/day was essential to ensure optimal growth in this cohort.
营养不良在先天性膈疝（CDH）幸存者中普遍存在。我们旨在描述该队列中从儿科重症监护病房（PICU）出院后12个月内的营养状况及影响生长的因素。
纳入2000年至2010年从PICU出院且随访至少12个月的CDH幸存者。记录营养摄入、人体测量和临床变量。采用多变量线性回归确定与12个月龄时年龄别体重Z评分（WAZ）相关的因素。
分析了110例婴儿的数据，其中67%为男性，50%采用补片修补术。该队列在PICU出院时WAZ的中位数（IQR）为-1.4（-2.4至-0.3），12个月时为-0.4（-1.3至0.2）。严重营养不良（WAZ<-2）的婴儿比例从26%降至8.5%（p<0.001）。补片修补术（p=0.009）、蛋白质摄入量<2.3g/kg/天（p=0.014）和出生体重（BW）<2.5kg（p<0.001）与12个月时较低的WAZ相关。
CDH幸存者在PICU出院后的12个月内营养状况有显著改善。补片修补术、较低的BW和蛋白质摄入不足是12个月时WAZ较低的重要预测因素。PICU中蛋白质摄入量至少为2.3g/kg/天对于确保该队列的最佳生长至关重要。
