{"title":"Calf circumference may complement the nutritional assessment of children under 10 in the paediatric intensive care unit.","authors":"Rafaela Rodrigues Vieira, Patrícia Zamberlan","doi":"10.1016/j.clnesp.2024.12.020","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Nutritional intervention during hospitalisation is vital in managing of children and adolescents in intensive care. In this context, body composition measurements, such as mid-upper arm circumference (MUAC), can help improve the accuracy of nutritional assessments. However, using MUAC has some limitations. Calf circumference (CC) is a straightforward, inexpensive, and easily obtainable measurement. However, no reference values currently exist for CC in paediatric patients.</p><p><strong>Aims: </strong>To describe the nutritional monitoring of critically ill children and adolescents in the Paediatric Intensive Care Unit (PICU) using CC.</p><p><strong>Methods: </strong>Patients aged 6 months to 18 years old who were admitted to the PICUs participated in the study. Two MUAC and CC measurements were performed: one in the first 48 h of admission to the PICU and another after 7 days. The percentage change between the two measurements was compared. Information was also evaluated about demographic and outcome data. Analyses were conducted with all patients included in the sample collectively and subdivided by age (<10 years and ≥10 years).</p><p><strong>Results: </strong>Two hundred and eleven patients underwent anthropometric assessment on admission, and the sample for comparative analyses consisted of 103 patients (after discharges and deaths). MUAC and CC significantly decreased in the first week of hospitalisation. A positive weak correlation was found between the percentage change in the MUAC and CC only for individuals under 10 years old and for the total sample, but not for adolescents. The all age group and children under 10 years old showed a greater reduction in CC than in MUAC. The same did not occur for adolescents.</p><p><strong>Conclusions: </strong>Calf circumference may be a promising method for nutritional monitoring of critically ill children in Paediatric Intensive Care Units because it can indicate signs of depletion earlier than mid-upper arm circumference. These results are more meaningful for children than for adolescents.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":"445-452"},"PeriodicalIF":2.9000,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical nutrition ESPEN","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/j.clnesp.2024.12.020","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Nutritional intervention during hospitalisation is vital in managing of children and adolescents in intensive care. In this context, body composition measurements, such as mid-upper arm circumference (MUAC), can help improve the accuracy of nutritional assessments. However, using MUAC has some limitations. Calf circumference (CC) is a straightforward, inexpensive, and easily obtainable measurement. However, no reference values currently exist for CC in paediatric patients.
Aims: To describe the nutritional monitoring of critically ill children and adolescents in the Paediatric Intensive Care Unit (PICU) using CC.
Methods: Patients aged 6 months to 18 years old who were admitted to the PICUs participated in the study. Two MUAC and CC measurements were performed: one in the first 48 h of admission to the PICU and another after 7 days. The percentage change between the two measurements was compared. Information was also evaluated about demographic and outcome data. Analyses were conducted with all patients included in the sample collectively and subdivided by age (<10 years and ≥10 years).
Results: Two hundred and eleven patients underwent anthropometric assessment on admission, and the sample for comparative analyses consisted of 103 patients (after discharges and deaths). MUAC and CC significantly decreased in the first week of hospitalisation. A positive weak correlation was found between the percentage change in the MUAC and CC only for individuals under 10 years old and for the total sample, but not for adolescents. The all age group and children under 10 years old showed a greater reduction in CC than in MUAC. The same did not occur for adolescents.
Conclusions: Calf circumference may be a promising method for nutritional monitoring of critically ill children in Paediatric Intensive Care Units because it can indicate signs of depletion earlier than mid-upper arm circumference. These results are more meaningful for children than for adolescents.
期刊介绍：
Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.
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