Monitoring MUAC reflects the adequacy of nutrition support in critically ill children with a longer intensive care unit stay: A single-center prospective cohort study.

IF 2.1 4区医学 Q3 NUTRITION & DIETETICS

Nutrition in Clinical Practice Pub Date : 2025-03-10 DOI:10.1002/ncp.11289

Yue Zhang, Zichen Fang, Xuelin Zhao, Xiaodong Zhu, Yueniu Zhu, Yi Feng

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引用次数: 0

Abstract

Background: Children who are critically ill frequently experience inadequate nutrition, resulting in changes in body composition. We investigated the nutrition status and body composition changes among children with prolonged stays in the pediatric intensive care unit (PICU), utilizing midupper arm circumference (MUAC), and triceps skinfold thickness (TSF) measurements.

Methods: A single-center prospective cohort study monitored nutrition support for children admitted to the PICU for over 6 days. MUAC and TSF were measured at admission and every other day through the 15th day of the PICU stay. Target energy was caculated using the Schofield formula without stress correction, and recommended protein intake was set at 1.5 g/(kg/d). Factors influencing changes in anthropometry were analyzed through pairwise correlation and regression analysis.

Results: Sixty children with a median PICU stay of 9 days were included. MUAC decreased by 2.53% in the first week and by 7.42% over 2 weeks. During the first week, average energy and protein intakes were only 53.0% and 41.3% of recommended levels, respectively. Decreases in MUAC correlated with mean cumulative energy deficits (1 week: r = 0.310 [P = 0.016]; 2 weeks: r = 0.504 [P = 0.023]) and mean cumulative protein deficits (1 week: r = 0.304 [P = 0.018]).

Conclusions: Many children with longer PICU stays did not met energy and protein recommendations. Decreases in MUAC were associated with deficits in energy and protein intake. Monitoring MUAC is a valuable tool for assessing nutrition support adequacy in children with longer PICU stays.

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监测MUAC反映了重症监护时间较长的危重儿童营养支持的充分性：一项单中心前瞻性队列研究。

背景：重症儿童经常营养不足，导致身体成分发生变化。我们利用中上臂围（MUAC）和肱三头肌皮褶厚度（TSF）测量方法，研究了长期入住儿科重症监护室（PICU）的儿童的营养状况和身体成分变化：一项单中心前瞻性队列研究对入住 PICU 超过 6 天的儿童的营养支持进行了监测。入院时测量MUAC和TSF，并在PICU住院的第15天内每隔一天测量MUAC和TSF。使用 Schofield 公式计算目标能量，不进行应力校正，并将推荐蛋白质摄入量设定为 1.5 克/（千克/天）。通过配对相关分析和回归分析对影响人体测量变化的因素进行了分析：共纳入 60 名儿童，其中 PICU 中位住院时间为 9 天。MUAC在第一周下降了2.53%，在两周内下降了7.42%。第一周的平均能量和蛋白质摄入量分别仅为建议水平的 53.0% 和 41.3%。MUAC的下降与平均累积能量不足（1周：r = 0.310 [P = 0.016]；2周：r = 0.504 [P = 0.023]）和平均累积蛋白质不足（1周：r = 0.304 [P = 0.018]）相关：结论：许多在儿童重症监护室住院时间较长的儿童没有达到能量和蛋白质推荐值。MUAC的下降与能量和蛋白质摄入不足有关。监测 MUAC 是评估 PICU 留院时间较长的患儿营养支持是否充足的重要工具。

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

Nutrition in Clinical Practice 医学-营养学

CiteScore

6.00

自引率

9.70%

发文量

128

审稿时长

3 months

期刊介绍： NCP is a peer-reviewed, interdisciplinary publication that publishes articles about the scientific basis and clinical application of nutrition and nutrition support. NCP contains comprehensive reviews, clinical research, case observations, and other types of papers written by experts in the field of nutrition and health care practitioners involved in the delivery of specialized nutrition support. This journal is a member of the Committee on Publication Ethics (COPE).