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ESICM LIVES 2016: part three

Article scientifique 2016 Anglais

Résumé

Introduction: Critically ill children in the pediatric intensive care unit (PICU) are at high risk for developing nutritional deficiencies and undernutrition is known to be a risk factor for morbidity and mortality. Malnutrition represents a continuous spectrum ranging from marginal nutrient status to severe metabolic and functional alterations and this in turn, affects clinical outcome. Objectives: The aim of the study was to assess nutritional status of critically ill children admitted to the PICU and its association to clinical outcomes. Methods: Critically ill children age 6 months to 18 years were prospectively enrolled on PICU admission. Nutritional status was assessed by weight for age (WFA: underweight), weight for height (WFH: wasting), height for age (HFA: stunting) z-scores and mid upper arm circumference (MUAC: wasting) according to the WHO. (1,2) Malnutrition was defined as mild, moderate, and severe if z-scores were > -1, > -2, and > -3, respectively. Hospital and PICU length of stay (LOS), duration of mechanical ventilation (MV), and risk of mortality (ROM) by the Pediatric Index of Mortality 2 (PIM2) were obtained. Sensitivity and specificity of the MUAC to identify children with wasting (WFH) were calculated. Results: Two hundred and fifty children (136 males), aged 81 months (23-167; median (25-75 th IQR)), were prospectively included in the study. The hospital LOS was 8 (4-16) days; PICU LOS: 2 (1-4) days; duration of MV, 0 (0-1.5) days; PIM2 ROM 2.61 0.25 %. WFA, WFH, and HFA z-scores of -0.48 0.14; 0.19 0.13; and -0.95 0.13 respectively; MUAC, 16.3 0.18 cm (6 to 59 months, n = 108); 24.2 0.46 cm (5 to 18 years, n = 142). The prevalence of underweight, wasting and stunting was 26.4 %, 19.6 %, and 44.4 % respectively. The sensitivity and specificity for MUAC vs. WFH to identify wasting was: 34.5 % (20.3-50.6; 95 % CI) and 95.5 % (91.8-97.9), respectively. Values are mean SE.

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Velasquez, T., Lusk, J., Kyle, U., Fontenot, T., Marshall, P., Shekerdemian, L., Nishigaki, A., Yatabe, T., Tamura, T., Yamashita, K., YOKOYAMA, M., Ruiz‐Rodríguez, J., Encina, B., Belmonte, R., Troncoso, I., Tormos, P., Baena-, J., Sánchez‐Pla, Á., Bañeras, J., Andrés-Cordón, J., Duran, N., Ruiz, A., Caballero, J., Nuvials, X., Serra, J., Rutten, A., Ieperen, S., Kinderen, E., Logten, T., Kovacikova, L., Skrak, P., Zahorec, M., Akcan-Arikan, A., Silva, J., Goldsworthy, M., Harrison, D., Parslow, R., Davis, P., Pappachan, J., Goodwin, S., Ramnarayan, P., Chernyshuk, S., Yemets, H., Zhovnir, V., Pulitano’, S., Rosa, S., Mancino, A., Villa, G., Tosi, F., Franchi, P., Conti, G., Patel, B., Khine, H., Shah, A., Sung, D., Singer, L., Haghbin, S., Inaloo, S., Serati, Z., Idei, M., Yamamoto, N., Sakai, Y., Matsuda, Y., Yamaguchi, Y., Takaki, S., Yamaguchi, O., Goto, T. (2016). ESICM LIVES 2016: part three. https://doi.org/10.1186/s40635-016-0100-7

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Auteur(s)

T. Velasquez J. Lusk Ursula G. Kyle Taylor Fontenot Peter Marshall L. S. Shekerdemian A. Nishigaki Tomoaki Yatabe T. Tamura Koichi Yamashita M. YOKOYAMA Juan Carlos Ruiz‐Rodríguez B. Encina R. Belmonte I. Troncoso Pau Micó Tormos Javier Baena- Álex Sánchez‐Pla J. Bañeras Joan F. Andrés-Cordón Nilüfer Ekşi Duran A. Ruiz J. Caballero X. Nuvials J Serra A Rutten S. N. M. van Ieperen E. P. H. M. Der Kinderen T. Van Logten L. Kovacikova P. Skrak Martin Zahorec A. Akcan-Arikan J. C. Silva Michelle Goldsworthy David A Harrison Roger Parslow Peter J. Davis Joseph M Pappachan S. Goodwin Padmanabhan Ramnarayan S. Chernyshuk H. Yemets Volodymyr Zhovnir S. M. Pulitano’ S. De Rosa Aldo Mancino Gianluca Villa F. Tosi Paola Franchi G. Conti Binisha Patel Hnin Khine Atul K. Shah Deborah Sung Leif Singer S. Haghbin Soroor Inaloo Zahra Serati M. Idei Natsuhiro Yamamoto Y. Sakai Y. Matsuda Y. Yamaguchi S. Takaki O. Yamaguchi T. Goto

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