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Text
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URL Address
<a href="http://doi.org/10.1590/s1516-31801998000600006" target="_blank" rel="noreferrer">http://doi.org/10.1590/s1516-31801998000600006</a>
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Title
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Metabolic assessment and enteral tube feeding usage in children with acute neurological diseases
Publisher
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Sao Paulo Medical Journal = Revista Paulista De Medicina
Date
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1998
Subject
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Child; Humans; Acute Disease; Preschool; infant; Nutritional Status; retrospective studies; Enteral Nutrition/adverse effects; Nervous System Diseases/metabolism/therapy; Nitrogen/urine; Urea/urine
Creator
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Leite HP; Fantozzi G
Description
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OBJECTIVE: To report on acquired experience of metabolic support for children with acute neurological diseases, emphasizing enteral tube feeding usage and metabolic assessment, and also to recommend policies aimed towards improving its implementation. DESIGN: Retrospective analysis. SETTING: Pediatric Intensive Care Unit of Hospital do Servidor Publico Estadual de Sao Paulo. SUBJECTS: 44 patients consecutively admitted to the Pediatric ICU over a period of 3 years who were given nutrition and metabolic support for at least 72 hours. Head trauma, CNS infections and craniotomy post-operative period following tumor exeresis were the main diagnoses. MEASUREMENTS: Records of protein-energy intake, nutrient supply route, nitrogen balance and length of therapy. RESULTS: From a total of 527 days of therapy, single parenteral nutrition was utilized for 34.3% and single enteral tube feeding for 79.1% of that period. 61.4% of the children were fed exclusively via enteral tube feeding, 9.1% via parenteral and 39.5% by both routes. The enteral tube feeding was introduced upon admission and transpyloric placement was successful in 90% of the cases. Feeding was started 48 hours after ICU admission. The caloric goal was achieved on the 7th day after admission, and thereafter parenteral nutrition was interrupted. The maximum energy supply was 104.2 +/- 23.15 kcal/kg. The median length of therapy was 11 days (range 4-38). None of the patients on tube feeding developed GI tract bleeding, pneumonia or bronchoaspiration episodes and, of the 4 patients who were given exclusive TPN, 2 developed peptic ulcer. The initial urinary urea nitrogen was 7.11 g/m2 and at discharge 6.44 g/m2. The protein supply increased from 1.49 g/kg to 3.65 g/kg (p < 0.01). The nitrogen balance increased from--7.05 to 2.2 g (p < 0.01). CONCLUSIONS: Children with acute neurological diseases are hypercatabolic and have high urinary nitrogen losses. The initial negative nitrogen balance can be increased by more aggressive feeding regimes than the usual ones. Early tube feeding was well tolerated, which permits the conclusion that it is a safe and effective method for nutrition support. Recommendations of basic rules for metabolic support are made.
1998
Identifier
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<a href="http://doi.org/10.1590/s1516-31801998000600006" target="_blank" rel="noreferrer">10.1590/s1516-31801998000600006</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
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Journal Article
1998
Acute Disease
Backlog
Child
Enteral Nutrition/adverse effects
Fantozzi G
Humans
Infant
Journal Article
Leite HP
Nervous System Diseases/metabolism/therapy
Nitrogen/urine
Nutritional Status
Preschool
Retrospective Studies
Sao Paulo Medical Journal = Revista Paulista De Medicina
Urea/urine