Berry Katarina G, Seiple Stephanie M, Stellar Judith J, Nagle Monica L, Curry Kelsey, Immel Amanda, James Richard, Srinivasan Vijay, Mascarenhas Maria R, Garrett Anna, Irving Sharon Y
Department of Clinical Nutrition, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Department of Nursing and General Surgery, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Transl Pediatr. 2021 Oct;10(10):2799-2813. doi: 10.21037/tp-21-3.
Nutrition status plays a critical role in pressure injury (PI) healing and yet the available literature, especially in pediatric patients, is limited. Critically ill pediatric patients are at an increased risk of skin integrity compromise and PI development. Adequate nutritional intake can often be challenging to achieve in this population and immobility and illness present additional obstacles to maintaining skin integrity in this vulnerable population. Despite the unique nutritional challenges and needs of this group, there is no standardized approach to macro- and micronutrient management and monitoring. Here, several key vitamins and minerals believed to play a role in PI healing are discussed and an approach to nutritional management and monitoring for PI healing in pediatric patients is proposed. Registered dietitians (RD) are essential to assess individual patient macro and micronutrient requirements, to identify gaps and make recommendations to optimize nutritional therapy that may exist and impact wound healing. We used a scoping review to focus on the interplay of nutrition and PI healing and inform a multidisciplinary approach to PI identification and management. Through this review, we propose a strategy for the nutritional management of pediatric patients <30 kg at risk for and who present with PI.
营养状况在压疮(PI)愈合中起着关键作用,但现有文献,尤其是关于儿科患者的文献有限。危重症儿科患者皮肤完整性受损和发生压疮的风险增加。在这一人群中,实现充足的营养摄入往往具有挑战性,而活动受限和疾病给维持这一脆弱人群的皮肤完整性带来了额外障碍。尽管该群体存在独特的营养挑战和需求,但对于宏量营养素和微量营养素的管理及监测尚无标准化方法。在此,讨论了几种被认为在压疮愈合中起作用的关键维生素和矿物质,并提出了一种针对儿科患者压疮愈合的营养管理和监测方法。注册营养师(RD)对于评估个体患者的宏量营养素和微量营养素需求、识别差距以及提出优化可能存在的影响伤口愈合的营养治疗建议至关重要。我们采用了一项范围综述来关注营养与压疮愈合的相互作用,并为压疮的识别和管理提供多学科方法。通过这项综述,我们提出了一种针对体重<30 kg且有发生压疮风险及已出现压疮的儿科患者的营养管理策略。