Khan Zahra, Marinschek Sabine, Pahsini Karoline, Scheer Peter, Morris Nicholas, Urlesberger Berndt, Dunitz-Scheer Marguerite
Department of Pediatrics, Medical University of Graz, Graz, Austria.
J Pediatr Gastroenterol Nutr. 2016 Jan;62(1):157-60. doi: 10.1097/MPG.0000000000000931.
The aim of the present study was to assess the nutritional status and growth of medically fragile children receiving long-term enteral nutritional support (ENS).
A retrospective cross-sectional survey was conducted at a tertiary-level pediatric hospital. Growth features and nutritional intake of children (n = 287) receiving ENS were evaluated. During a period of 5 years (2009-2013), study patients in the age group of 1 to 36 months had been referred for the explicit reason of tube weaning. Data were documented with the help of ARCHIMED (version 46.2) and analyzed using SPSS for Windows version 21. Nutritional/growth status was determined by using World Health Organization growth standard tables.
Anthropometric parameters of children were compared with World Health Organization standards, and the prevalence of underweight, wasting, and stunting was very high despite being exclusively or predominantly on ENS. Results revealed that the age of a child, inadequate amount of caloric supply/day, the diagnosis of small-for-gestational age, and the type of tube (nasogastric tube) were significantly associated with growth/nutritional status (P < 0.05). Duration of ENS in the percentage of the cohort's lifetime and the main diagnosis were not associated with nutritional/growth outcomes.
In medically fragile children, ENS does not ensure adequate growth per se. ENS requires highly specialized and individually tailored management and in many cases regular adjustments. Long-term tube feeding plans often seem unable to ensure the required amount of nutritional support, which surely compromise the individual efficacy of ENS.
本研究旨在评估接受长期肠内营养支持（ENS）的医学脆弱儿童的营养状况和生长情况。
在一家三级儿科医院进行了一项回顾性横断面调查。对接受ENS的儿童（n = 287）的生长特征和营养摄入进行了评估。在5年期间（2009 - 2013年），年龄在1至36个月的研究患者因明确的脱管原因被转诊。数据借助ARCHIMED（版本46.2）记录，并使用Windows版SPSS 21进行分析。营养/生长状况通过使用世界卫生组织生长标准表来确定。
将儿童的人体测量参数与世界卫生组织标准进行比较，尽管完全或主要接受ENS，但体重不足、消瘦和发育迟缓的患病率非常高。结果显示，儿童年龄、每日热量供应不足、小于胎龄儿诊断以及导管类型（鼻胃管）与生长/营养状况显著相关（P < 0.05）。ENS在队列寿命百分比中的持续时间和主要诊断与营养/生长结果无关。
在医学脆弱儿童中，ENS本身并不能确保足够的生长。ENS需要高度专业化且个性化定制的管理，并且在许多情况下需要定期调整。长期管饲计划往往似乎无法确保所需的营养支持量，这肯定会损害ENS的个体疗效。
