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Malnutrition in critically ill children: From admission to 6 months after discharge

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Author: Hulst, J. · Joosten, K. · Zimmermann, L. · Hop, W. · Buuren, S. van · Büller, H. · Tibboel, D. · Goudoever, J. van
Type:article
Date:2004
Institution: TNO Preventie en Gezondheid
Source:Clinical Nutrition, 2, 23, 223-232
Identifier: 237687
doi: doi:10.1016/S0261-5614(03)00130-4
Keywords: Anthropometry · Children · Critical illness · Follow-up · Nutritional assessment · Standard deviation scores · Anamnesis · Child nutrition · Clinical observation · Controlled study · Female · Hospital admission · Hospital discharge · Intensive care unit · Length of stay · Major clinical study · Male · Medical parameters · Newborn intensive care · Outcomes research · Prematurity · Prospective study · Adolescent · Child · Child, Preschool · Critical Illness · Hospitalization · Humans · Infant · Infant, Newborn · Infant, Premature · Intensive Care · Intensive Care, Neonatal · Length of Stay · Malnutrition · Nutritional Status · Patient Discharge

Abstract

Background & Aims: Little is known about the nutritional status of critically ill children during hospitalisation in and after discharge from an intensive care unit. We set up a prospective, observational study to evaluate the nutritional status of children in an intensive care unit from admission up to 6 months after discharge. A secondary aim was identifying patient characteristics that influence the course of the various anthropometric parameters. Methods: The nutritional status of 293 children - 104 preterm neonates, 96 term neonates and 93 older children - admitted to our multidisciplinary tertiary pediatric and neonatal intensive care unit was evaluated by anthropometry upon and during admission, at discharge and 6 weeks and 6 months following discharge. Results: Upon admission, 24% of all children appeared to be undernourished. Preterm and term neonates, but not older children, showed a decline in nutritional status during admission. At 6 months after discharge almost all children showed complete recovery of nutritional status. Length of stay and history of disease were the parameters that most adversely affected the nutritional status of preterm and term neonates at discharge and during follow-up. Conclusion: While malnutrition is a major problem in pediatric intensive care units, most children have good long-term outcome in terms of nutritional status after discharge. © 2003 Elsevier Ltd. All rights reserved.