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评估在手术前后为新生儿和儿童提供营养支持的实践与挑战,及其对恢复和预后的影响。

Assessing Practices and Challenges in Providing Nutritional Support to Neonates and Children Pre- and Post-Surgery, and its Impact on Recovery and Outcomes.

作者信息

Sahu Shyam Sundar, Singh Abhishek Kumar, Das Kiran Shankar, Ranjan Abhishek, Lakra Priya Shalini, Kumar Abhijit

机构信息

Department of Paediatric Surgery, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India.

Department of Neonatology, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India.

出版信息

J Pharm Bioallied Sci. 2024 Jul;16(Suppl 3):S2833-S2835. doi: 10.4103/jpbs.jpbs_353_24. Epub 2024 Jul 31.

Abstract

BACKGROUND

Providing adequate nutritional support to neonates and children undergoing surgery is crucial for their recovery and overall health outcomes. However, there are various challenges associated with this, including the unique nutritional requirements of this population and the potential complications that can arise pre- and post-surgery.

MATERIALS AND METHODS

This study aimed to assess the practices and challenges in providing nutritional support to neonates and children both pre- and post-surgery, and to analyze its impact on recovery and outcomes. A retrospective analysis was conducted on a cohort of 200 neonates and children who underwent surgery over a two-year period. Data regarding preoperative nutritional status, types of nutritional support provided, postoperative complications, and recovery outcomes were collected and analyzed.

RESULTS

The study found that 65% of neonates and children were malnourished preoperatively, with 45% experiencing delays in initiating enteral feeding post-surgery due to complications such as gastrointestinal intolerance and surgical complications. Among those who received parenteral nutrition, 30% developed catheter-related bloodstream infections. Overall, the mean length of hospital stay was prolonged by 7 days in malnourished patients compared to adequately nourished patients.

CONCLUSION

Effective nutritional support in neonates and children undergoing surgery is essential for optimal recovery and outcomes. However, significant challenges exist, including preoperative malnutrition, delays in initiating enteral feeding, and complications associated with parenteral nutrition. Strategies to optimize nutritional status preoperatively, minimize postoperative complications, and enhance nutritional support are imperative to improve outcomes in this vulnerable population.

摘要

背景

为接受手术的新生儿和儿童提供充足的营养支持对其康复及整体健康状况至关重要。然而,与此相关存在各种挑战,包括该人群独特的营养需求以及手术前后可能出现的并发症。

材料与方法

本研究旨在评估在手术前后为新生儿和儿童提供营养支持的做法及挑战,并分析其对康复和结局的影响。对一组在两年期间接受手术的200名新生儿和儿童进行了回顾性分析。收集并分析了有关术前营养状况、提供的营养支持类型、术后并发症及康复结局的数据。

结果

研究发现,65%的新生儿和儿童术前营养不良,45%的患儿术后因胃肠不耐受和手术并发症等原因在开始肠内喂养方面出现延迟。在接受肠外营养的患儿中,30%发生了导管相关血流感染。总体而言,与营养充足的患者相比,营养不良患者的平均住院时间延长了7天。

结论

为接受手术的新生儿和儿童提供有效的营养支持对实现最佳康复和结局至关重要。然而,存在重大挑战,包括术前营养不良、开始肠内喂养延迟以及与肠外营养相关的并发症。术前优化营养状况、尽量减少术后并发症以及加强营养支持的策略对于改善这一脆弱人群的结局至关重要。

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本文引用的文献

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Nutrition support in the pediatric surgical patient.儿科外科患者的营养支持。
Surg Clin North Am. 2011 Jun;91(3):511-41. doi: 10.1016/j.suc.2011.02.008.

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