Parenteral nutrition customization in pediatrics: A descriptive cohort study.

IF 3.2 3区 医学 Q2 NUTRITION & DIETETICS
Jéssica Lavanholi Pinho, Renata Germano Borges de Oliveira Nascimento Freitas, Roberto Jose Negrão Nogueira
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引用次数: 0

Abstract

Objectives: The main objective of this study was to analyze the reasons for customizing parenteral nutrition (PN) in pediatric patients admitted to a quaternary hospital.

Methods: We performed a descriptive cohort study on 264 hospitalized children receiving PN. Anthropometric, biochemical, and hospitalization data were collected from patient records. Unequivocal reasons for customizing PN were defined as situations precluding prescription of a standard adult/teenager PN and included renal and/or liver failure, energy-protein adequacy, and elevated mineral and triglyceride levels.

Results: A total of 264 patients, with a median age of 2.2 years (IQR: 0.3-9.0 years), comprising intensive care (n = 216; 81.8%) and malnourished (n = 91; 36.1%) patients, were evaluated. In the first 48 h, 87.9% (n = 232) of the sample required customized PN for energy-protein adequacy (210 of 232), maintained over subsequent days in most cases. Among patients requiring second individualization, mineral disturbance was the main reason observed, especially within the first 4 days of PN use (n = 21; 60%). Unequivocal reasons for customizing PN occurred in 97.4% (n = 226) of cases in the first 48 h; 96.2% (n = 177) of cases on the fourth day; and 90.1% (n = 92) of cases on the seventh day of PN use. An inverse correlation was found between weight/age z score and number of second individualizations (r = -0.222; P = 0.002).

Conclusion: Customized PN proved essential, especially for younger, malnourished, and intensive care patients. Investment in training a Nutritional Multidisciplinary Therapy Team and acquiring a specific electronic system for prescribing PN is suggested.

儿科肠外营养定制:一项描述性队列研究。
研究目的本研究的主要目的是分析在一家四级医院住院的儿科患者定制肠外营养(PN)的原因:我们对 264 名接受肠外营养的住院儿童进行了描述性队列研究。我们从病历中收集了人体测量、生化和住院数据。定制 PN 的不明确原因被定义为无法处方标准成人/青少年 PN 的情况,包括肾脏和/或肝脏功能衰竭、能量蛋白不足、矿物质和甘油三酯水平升高:共评估了 264 名患者,中位年龄为 2.2 岁(IQR:0.3-9.0 岁),包括重症监护患者(216 人;81.8%)和营养不良患者(91 人;36.1%)。在最初的 48 小时内,87.9% 的样本(n = 232)需要定制 PN 以保证能量-蛋白质充足(232 人中有 210 人),在大多数情况下,这种情况会持续几天。在需要进行第二次个体化治疗的患者中,矿物质紊乱是主要原因,尤其是在使用 PN 的前 4 天内(21 人;60%)。在使用 PN 的前 48 小时,97.4% 的病例(n = 226)、96.2% 的病例(n = 177)和 90.1%的病例(n = 92)在使用 PN 的第 7 天出现了定制 PN 的明确原因。体重/年龄 Z 值与第二次个体化治疗次数之间存在反相关关系(r = -0.222;P = 0.002):结论:事实证明,定制的 PN 是必不可少的,尤其是对于年轻、营养不良和重症监护患者。建议投资培训一个多学科营养治疗小组,并购置一个专门的电子系统来开具营养处方。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
7.80
自引率
8.80%
发文量
161
审稿时长
6-12 weeks
期刊介绍: The Journal of Parenteral and Enteral Nutrition (JPEN) is the premier scientific journal of nutrition and metabolic support. It publishes original peer-reviewed studies that define the cutting edge of basic and clinical research in the field. It explores the science of optimizing the care of patients receiving enteral or IV therapies. Also included: reviews, techniques, brief reports, case reports, and abstracts.
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