Pediatrics |

Malnutrition in Critically Ill Children and Its Impact on Their Clinical Course FREE TO VIEW

Hilda Diaz-Escalera*, MD; Anabel Puig-Ramos, PhD; Alicia Fernández-Sein, MD; Gilberto Puig-Ramos, MD; Ricardo García-De Jesús, MD
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UPR-School of Medicine Department of Pediatrics, Critical Care Section, San Juan, Puerto Rico

Chest. 2012;142(4_MeetingAbstracts):760A. doi:10.1378/chest.1390854
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SESSION TYPE: Pediatric Critical Care

PRESENTED ON: Sunday, October 21, 2012 at 01:15 PM - 02:45 PM

PURPOSE: Malnutrition has shown to be associated with increased morbidity and mortality in both children and adults, including a higher risk of infections due to poor immune defense, wound healing problems, longer dependency on mechanical ventilation and longer hospital stay. In this study we evaluated the prevalence of acute and chronic malnutrition and their impact on clinical outcomes in patients admitted to the Pediatric Intensive Care Unit (PICU) of the University Pediatric Hospital.

METHODS: We retrospectively analyzed the records of 101 consecutive admissions to PICU from 01/01/10 to 07/31/10. Patients less than 48 hours of admission were excluded. Acute malnutrition was defined as weight-for-height (WFH) < 2 SD or less than 5th percentile and chronic malnutrition was defined as height-for-age (HFA) < 2 SD or less than 5th percentile.

RESULTS: Chronic malnutrition was observed in 22% of patients admitted to PICU, whereas only 6% of the admissions had acute malnutrition. Respiratory pathology was the most common admission diagnosis among malnourished patients. Neither acute nor chronic malnutrition affect length of hospital stay, mortality rate or use of inotropics. Patients with chronic malnutrition showed a trend toward spending more days on mechanical ventilation support.

CONCLUSIONS: This study showed a significant incidence of chronic malnutrition in patients admitted to PICU for respiratory problems. We will expand the study period to one year to increase the number of patients evaluated to identify co-morbidities and correlate their impact in chronic malnutrition and prolonged intensive care therapy. We will also include in the analysis patients admitted to the PICU at the San Jorge Children's Hospital for the same study period to determine the malnutrition status of these patients and what is their impact on patient's clinical course.

CLINICAL IMPLICATIONS: Knowing the nutritional status of critically ill children may help physicians to predict if patients are going to spend more time on mechanical ventilation as well if they will have a greater morbidity and mortality.

DISCLOSURE: The following authors have nothing to disclose: Hilda Diaz-Escalera, Anabel Puig-Ramos, Alicia Fernández-Sein, Gilberto Puig-Ramos, Ricardo García-De Jesús

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UPR-School of Medicine Department of Pediatrics, Critical Care Section, San Juan, Puerto Rico




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