Identification and Management of Acute Malnutrition in Hospitalized Children

Abstract

D uring the past 3 decades, there has been an increased awareness of malnutrition (undernutrition) in developed countries. In contrast to developing countries where most of the childhood malnutrition is related to food insecurity and poverty, a majority of malnourished children in developed countries are secondarily malnourished because of a specific, usually chronic disorder. Severe acute malnutrition constitutes a small proportion of all malnutrition in this setting, yet accounts for a disproportionately high risk of morbidity and mortality and, once identified, is considered a medical emergency. This review focuses on the identification and management of acute malnutrition in hospitalized children in developed countries. METHODSA search was conducted of PubMed and Cochrane databases for studies and reviews on the topic of acute malnutrition in hospitalized children in developed countries. The search was limited to articles in English published in the past 5 years. Articles that were published more than 5 years ago were included if relevant. The authors focused their search and included all the studies that contained the following key words: prevalence of malnutrition in developed countries, definition of malnutrition, outcomes, and management.

The Relevance of Assessment of Nutritional Status in Children with Chronic Heart Failure

“…Увеличение энер-гетических затрат в покое связано с необходимостью поддержания функционирования миокарда и дыхатель-ной мускулатуры, обеспечения базовых метаболических функций, поддержания терморегуляции. Энергетические затраты на поддержание этих функций при сердечной недостаточности резко возрастают [5,7,21], а при физи-ческой активности могут превышать таковые у соответ-ствующих по возрасту здоровых детей до 2,5 раз [12,21].…”

“…ХСН -одна из наиболее сложных проблем здравоох-ранения развитых стран мира, а также одна из главных причин инвалидизации и высокой смертности в детском возрасте [7,8]. Независимо от причины и функциональ-ного класса ХСН ежегодная летальность детей с этим заболеванием составляет около 10-12% (даже в услови-ях лечения в специализированном стационаре), а пяти-летняя выживаемость -менее 50% [9].…”

Prevalence of Under-nutrition in Hospitalized Children in Aswan University Hospital

“…Undernourished children who require hospital care are at risk of staying for a longer duration in hospital and have a worse clinical outcome as compared to children with normal nutrition 9 . Medical conditions leading to an increased risk of under-nutrition in children requiring hospital care 10 .…”