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Proposal for An Algorithm for Screening for Undernutrition in Hospitalized Children
Koen Huysentruyt1, Jean De Schepper, Patrick Bontems
1*Department of Pediatric Gastroenterology, Universitair Ziekenhuis Brussel †Vakgroep Pediatrie, Faculteit Geneeskunde en Farmacie, Vrije Universiteit Brussel (VUB), Brussels ‡Department of Pediatrics, Centre Hospitalier Universitaire Tivoli, La Louviere §Academic Hospital Erasme, Université Libre de Bruxelles, Brussels ||Department of Pediatrics, Jessa hospital, Hasselt ¶Department of Pediatrics, ZNA Paloa Kinderziekenhuis, Antwerpen #Environment and Health, Department of Public Health and Primary Care, KU Leuven-University of Leuven, Leuven **Department of Pediatric Gastroenterology, Ghent University Hospital, Ghent University, Ghent, Belgium.
Insights
Disease-related undernutrition remains a significant issue in hospitalized children across Europe. This study introduces a practical algorithm for nutritional screening and care programs to prevent deterioration during hospital stays.
Area of Science:
- Pediatric Nutrition
- Hospital Medicine
- Public Health
Background:
- Disease-related undernutrition is prevalent in hospitalized European children, with rates from 4.0% to 9.3%.
- Existing nutritional screening strategies aim to detect and prevent undernutrition, enabling timely interventions.
- Nutritional deterioration during hospital stays remains a concern for pediatric patients.
Purpose of the Study:
- To provide a practical guideline for implementing a nutritional care program in hospitalized children.
- To differentiate between nutritional status at admission and nutritional risk during hospitalization.
- To develop and propose a nutritional care algorithm for pediatric populations.
Main Methods:
- Development of a nutritional care algorithm based on the Deming quality control circle principle.
- Focus on distinguishing nutritional status from nutritional risk in pediatric patients.
- Inclusion of detailed instructions tailored for the pediatric population.
Main Results:
- A practical, algorithm-based guideline for nutritional care in hospitalized children is presented.
- The algorithm aims to facilitate the implementation of nutritional support and prevent deterioration.
- The proposed algorithm serves as a foundation for broader European guidelines.
Conclusions:
- The developed nutritional care algorithm offers a structured approach to managing undernutrition in hospitalized children.
- Implementation of this algorithm can potentially improve nutritional outcomes for pediatric patients.
- Further research is needed to validate the algorithm's applicability and effectiveness in diverse settings.
Abstract:
The prevalence of disease-related undernutrition in hospitalized children has not decreased significantly in the last decades in Europe. A recent large multicentric European study reported a percentage of underweight children ranging across countries from 4.0% to 9.3%. Nutritional screening has been put forward as a strategy to detect and prevent undernutrition in hospitalized children. It allows timely implementation of adequate nutritional support and prevents further nutritional deterioration of hospitalized children. In this article, a hands-on practical guideline for the implementation of a nutritional care program in hospitalized children is provided. The difference between nutritional status (anthropometry with or without additional technical investigations) at admission and nutritional risk (the risk of the need for a nutritional intervention or the risk for nutritional deterioration during hospital stay) is the focus of this article. Based on the quality control circle principle of Deming, a nutritional care algorithm, with detailed instructions specific for the pediatric population was developed and implementation in daily practice is proposed. Further research is required to prove the applicability and the merit of this algorithm. It can, however, serve as a basis to provide European or even wider guidelines.
