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[Nutritional status in pediatric intermediate care: Assessment at admission, progression during the stay and after
A Hubert1, C Ford-Chessel2, J Berthiller3
1Université Claude-Bernard Lyon 1, 43, boulevard du 11-Novembre-1918, 69100 Villeurbanne, France.
Insights
Malnutrition is common in pediatric intermediate care, affecting nearly a quarter of children at admission and developing during their stay. Early nutritional assessment and monitoring are crucial for recovery.
Area of Science:
- Pediatric critical care
- Nutritional science
- Clinical nutrition
Background:
- Malnutrition is a significant cause of morbidity but understudied in pediatric intermediate care units.
- Understanding nutritional status in this population is essential for improving patient outcomes.
Purpose of the Study:
- To determine the prevalence of malnutrition in children admitted to a pediatric intermediate care unit.
- To investigate the association between nutritional status and illness severity.
- To identify risk factors for malnutrition and track recovery post-discharge.
Main Methods:
- A prospective longitudinal study involving 459 children aged 5 days to 18 years.
- Nutritional status assessed using weight, height, BMI, and growth curves at admission, during stay, and up to 3 months post-discharge.
- Data collected by a dedicated nutrition support team at a university pediatric intermediate care unit.
Main Results:
- Malnutrition was detected in 23.8% of children at admission (20.5% acute, 6.8% chronic).
- Acquired malnutrition occurred in up to 26% of children during their stay, with dyspnea as a risk factor.
- Chronic disease and young age were risk factors for admission malnutrition; recovery was slow, with 66% achieving normal status by 2 months.
Conclusions:
- High prevalence of malnutrition at admission and during the stay in pediatric intermediate care.
- Systematic nutritional assessment at admission, continuous monitoring, and tailored support are vital.
- Early and individualized nutritional interventions are recommended for better patient outcomes.
Introduction:
Malnutrition, known as a cause of morbidity, has not been studied in children admitted to pediatric intermediate care units. This study aimed to describe the association between patients' nutritional status and the relative severity of illness that characterizes this population.
Patients And Methods:
In this prospective longitudinal study, a dedicated nutrition support team assessed the nutritional status of all children, aged 5 days to 18 years, admitted to our university pediatric intermediate care unit (Hôpital Femme-Mère-Enfants, Lyon, France) over one year (2012-2013). Weight, height, body mass index, weight-for-age ratio, height-for-age ratio, and the analysis of growth curves were collected at admission. We monitored patients' weight, which allowed us to detect malnutrition occurrence during the stay, and its progression up to 3 months after discharge.
Results:
A total of 459 patients were enrolled. Based on the analysis integrating all nutritional indices and the progression of growth curves, malnutrition at admission was detected in 23.8% of children (20.5% and 6.8% suffered from acute and chronic malnutrition, respectively). Based only on the body mass index, malnutrition was detected in 15.5% of children. Chronic disease appeared as a risk factor for malnutrition at admission (P=0.0001) and young age for acute malnutrition (P=0.04). The incidence of acquired malnutrition during the stay (in children with a length of stay > 5 days) was up to 26%, and dyspnea was the only risk factor identified. This population recovered with a normal nutritional status late (66% after 2 months and 16% after 3 months).
Conclusions:
The prevalence of malnutrition is high in our pediatric intermediate care unit. The occurrence of acquired malnutrition during the stay is frequent. All children should benefit from systematic nutritional assessment at admission as well as careful monitoring during the stay and after discharge, to adapt early and individualized nutritional support.
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