Almeida Santos L, Ruza F, Guerra A J, Alves A, Dorao P, García S, Santos N T
Unidad de Cuidados Intensivos Pediátricos, Hospital Infantil La Paz, Madrid.
An Esp Pediatr. 1998 Jul;49(1):11-6.
Protein-energy malnutrition (PEM) constitutes an important complication in children submitted to intensive care treatment for respiratory failure (RF). This complication is not usually evaluated in assessment protocols. Nutrition assessment in a Pediatric Intensive Care Unit (PICU) was performed in children with respiratory failure.
A prospective study involving 65 children (1-158 months of age) with RF at admission to the PICU was carried out. The patients studied were divided into four groups according to their etiology: Group I (n = 29) included those with acute bronchial pathology; Group II (n = 17) those with pneumonia: Group III (n = 11) those in the post-operative period following cardiac surgery; and Group IV (n = 8) those patients with multiple-organ dysfunction. All patients in Groups I, II, and III had chronic diseases. Anthropometrical and nutritional evaluation included weight, height and body mass index (w/h2).
The weight for age was low (59%). Height deficit was observed in a significantly lower percentage of the patients (13.1%). The body mass index showed values in relationship to the 50th percentile that varied between 83.4 +/- 23.1% and 97.1 +/- 4.7%. In 68.9% of the patients the criteria of global malnutrition were met according to the classification of McLaren and Read.
The data confirm that PEM is frequent in patients with RF in the PICU and emphasize the usefulness of anthropometrical evaluation as an important, simple and non-invasive method of nutritional evaluation. Early and intensive nutritional intervention can reduce or prevent the vicious circle of malnutrition in RF patients hospitalized in the PICU.
蛋白质-能量营养不良(PEM)是接受呼吸衰竭(RF)重症监护治疗的儿童的一种重要并发症。该并发症在评估方案中通常未得到评估。对呼吸衰竭儿童在儿科重症监护病房(PICU)进行营养评估。
对65名入住PICU时患有RF的儿童(年龄1至158个月)进行了一项前瞻性研究。根据病因将研究患者分为四组:第一组(n = 29)包括患有急性支气管病变的患者;第二组(n = 17)为肺炎患者;第三组(n = 11)为心脏手术后的患者;第四组(n = 8)为多器官功能障碍患者。第一、二、三组的所有患者均患有慢性病。人体测量和营养评估包括体重、身高和体重指数(体重/身高²)。
年龄别体重偏低者占59%。身高不足的患者比例明显较低(13.1%)。体重指数与第50百分位数相比,数值在83.4±23.1%至97.1±4.7%之间变化。根据麦克拉伦和里德的分类,68.9%的患者符合整体营养不良标准。
数据证实PEM在PICU中患有RF的患者中很常见,并强调人体测量评估作为一种重要、简单且非侵入性营养评估方法的实用性。早期和强化营养干预可减少或预防入住PICU的RF患者营养不良的恶性循环。