A Training Program for Anthropometric Measurements by a Dedicated Nutrition Support Team Improves Nutritional Status Assessment of the Critically Ill Child*

Abstract

This is the first study, showing that a targeted nutritional assessment teaching program that highlights both the importance and techniques of anthropometrical measurements has successfully been implemented in a PICU. It managed to improve staff knowledge and nutritional practice.

Energy and Protein Delivery in Overweight and Obese Children in the Pediatric Intensive Care Unit

“…A recent international, multicenter study reporting on clinical outcomes in critically ill children based on nutrition status by BMI z score emphasized the importance of identifying not only undernourished but also overweight and obese critically ill children 6 . However, providers are not confident in completing nutrition assessments 25 . The use of nutrition support teams and algorithms that include early nutrition assessments and education regarding nutrition assessments have been shown to improve nutrition practices 25 – 28 .…”

“…However, providers are not confident in completing nutrition assessments 25 . The use of nutrition support teams and algorithms that include early nutrition assessments and education regarding nutrition assessments have been shown to improve nutrition practices 25 – 28 . A nutrition evaluation should include a measure of body composition, as has been recommended by ASPEN's new definition for malnutrition, given the great risk for loss of lean body mass and association with worse clinical outcomes and severe disease in obesity 7 , 24 , 29 , 30 .…”

“…Determining overweight/obesity by any of these measures is also influenced by limitations in anthropometric measurements in the PICU. A recent study identified only one‐third of PICU patients to have anthropometric measurements on admission 25 . In addition, when anthropometric measurements are obtained, fluid shifts and limitations in patient movement and positioning can also result in inaccurate measurements.…”

Response to “Pediatric Intensive Care Nutrition Guidelines 2017: Key Questions Remain Unanswered”

“…We believe that anthropometric measurements should be a cornerstone of nutrition assessment in the critically ill. We do agree that some of these measurements may be problematic in a small proportion of children; however, accurate measurements can be made in the vast majority of critically ill children. 4,5 Accurate weight and height guide fluid, ventilator, and drug prescriptions in this vulnerable cohort. With increased awareness and training, accurate anthropometry can be obtained in most critically ill children.…”

Avaliação do estado nutricional de crianças e adolescentes na admissão em uma unidade de terapia intensiva pediátrica

“…São medidas simples, reprodutíveis e de baixo custo; contudo podem ser influenciadas por edema. Estas simples medidas habilitam o cálculo do Índice de Massa Corporal (IMC), razão do Peso/Estatura (P/E), razão Estatura/Idade (E/I) e razão Peso/Idade (P/I) 5 . A avaliação nutricional completa torna-se muito importante em pacientes pediátricos, pois crianças podem desnutrir mais rapidamente, quando comparamos com adultos 6 .…”