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Parenteral nutrition compatibility and stability: Practical considerations. 肠外营养的兼容性和稳定性:实际考虑因素。
IF 2.1 4区 医学 Q3 NUTRITION & DIETETICS Pub Date : 2024-10-01 Epub Date: 2024-07-12 DOI: 10.1002/ncp.11189
Joseph I Boullata, Genene Salman, Jay M Mirtallo, Todd W Canada, Jessica Monczka, Kathleen M Gura, Paul Kiritsy

Parenteral nutrition (PN) is a complex preparation that contains multiple component products with the associated risk for incompatibilities and diminished stabilities when combined together as an admixture. Significant patient harm can result from prescribing, preparing, and administering PN without confirming compatibility and stability. Incompatibility or instability is rarely obvious to the unaided eye, so safe PN admixture relies on incorporating physicochemical properties of the included components into compatibility and stability decisions. Practices include applying active ingredient concentration limits to reduce risk for incompatibilities and instabilities. The purpose of the current article is to distill the wide-ranging information on PN compatibility and stability into a feasible blueprint that individual healthcare organizations can then use to design and implement practical initiatives. Compatibility and stability considerations can be incorporated into the routine tasks of PN prescribing, order reviewing, preparing, and administering. The focus of this review is on identifying potential physicochemical interactions that can be addressed at each step in the PN use process. Organizations should incorporate compatibility and stability considerations into the routine procedures and practices of all clinicians involved with PN therapy. Those clinicians in healthcare organizations and caregivers in the home should then be in a position to safely provide the appropriate PN admixtures in terms of compatibility and stability.

肠外营养(PN)是一种复杂的制剂,包含多种成分产品,当它们作为混合物结合在一起时,会有不相容和稳定性降低的风险。在未确认兼容性和稳定性的情况下开具、配制和使用肠外营养制剂,可能会对患者造成重大伤害。不相容性或不稳定性在肉眼下很少能看出来,因此安全的 PN 混合物依赖于将所含成分的物理化学特性纳入相容性和稳定性决策。做法包括应用活性成分浓度限制,以降低不相容和不稳定的风险。本文旨在将有关 PN 兼容性和稳定性的广泛信息提炼成一个可行的蓝图,供各医疗机构用于设计和实施切实可行的措施。可将兼容性和稳定性方面的考虑因素纳入 PN 处方、医嘱审核、准备和给药等常规工作中。本综述的重点在于识别 PN 使用过程中每一步都可能发生的理化相互作用。医疗机构应将兼容性和稳定性考虑因素纳入所有参与 PN 治疗的临床医生的常规程序和实践中。这样,医疗机构中的临床医生和家庭护理人员就能安全地提供兼容性和稳定性适当的 PN 混合物。
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引用次数: 0
Applying the 2022 ASPEN adult nutrition support guidelines in a 2024 ICU. 在 2024 年重症监护病房应用 2022 年 ASPEN 成人营养支持指南。
IF 2.1 4区 医学 Q3 NUTRITION & DIETETICS Pub Date : 2024-10-01 Epub Date: 2024-07-30 DOI: 10.1002/ncp.11188
Sarah V Cogle, Madeleine Hallum, Diana W Mulherin

An update to the American Society for Parenteral and Enteral Nutrition guidelines for nutrition provision in critically ill adults was published in 2022. In contrast to the previous set of guidelines published in 2016, the revised guidelines selected only studies meeting specific criteria for scientific rigor and only considered publications reflecting more modern intensive care unit (ICU) practices (studies between January 1, 2001, and July 15, 2020). No consensus recommendations were included. Although these methods limited the number of recommendations made and the applicability to current ICU practices, important implications for patient care were evaluated and acknowledged. The literature supporting guideline recommendations that impact parenteral nutrition management is summarized in this review, along with key studies published after the guidelines were revised. Considerations for practical application of this evidence, along with limitations and future guideline directions, are also described.

美国肠外肠内营养学会于 2022 年发布了成人重症患者营养供应指南的更新版。与 2016 年发布的上一套指南相比,修订版指南只选择了符合科学严谨性特定标准的研究,并且只考虑了反映更现代重症监护室 (ICU) 实践的出版物(2001 年 1 月 1 日至 2020 年 7 月 15 日期间的研究)。未纳入共识建议。尽管这些方法限制了所提建议的数量以及对当前 ICU 实践的适用性,但对患者护理的重要影响还是得到了评估和认可。本综述总结了支持对肠外营养管理有影响的指南建议的文献,以及指南修订后发表的主要研究。此外,还介绍了实际应用这些证据的注意事项、局限性以及未来的指南方向。
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引用次数: 0
Oral health access and self-reported outcomes in patients with chronic intestinal failure requiring home intravenous support. 需要家庭静脉支持的慢性肠功能衰竭患者的口腔保健机会和自我报告结果。
IF 2.1 4区 医学 Q3 NUTRITION & DIETETICS Pub Date : 2024-10-01 Epub Date: 2024-08-05 DOI: 10.1002/ncp.11196
Emma J Osland, Swati Bhatt, Melanie Nelms, Kelsey Pateman

Background: Patients with chronic intestinal failure (CIF) may be predisposed to poor oral health outcomes. This study explored the self-reported oral health status, function, and psychological impacts of oral health of adult patients with CIF, their access to dental care, and how these compare with the broader population.

Methods: All patients >18 years old receiving home intravenous therapies for CIF were invited to complete a self-reported questionnaire providing information on oral health status and access to oral health services. Collateral information was provided by treating clinicians. Descriptive data analysis was undertaken, including subgroup analysis of clinical characteristics, and was compared with the available population-level data.

Results: Twenty-four patients participated. Short gut and dysmotility accounted for 88% of the etiologies of CIF. Respondents reported good preventative oral health behaviors (96%), accessing dental care within the last 12 months (75%), and limited barriers to receiving care. Dry mouth (96%), oral pain (59%), and temperature sensitivity (60%) were commonly reported across the cohort. Smoking history and reduced oral diet were associated with significantly worse self-reported oral health outcomes. Patients with CIF reported worse oral health outcomes despites better oral health access than the general population.

Conclusion: Patients with CIF appear to be at risk of poor oral health outcomes, especially where smoking or reduced oral intake are concurrently involved. Clinicians involved in CIF care should be alert to the oral health needs of this population and consider oral and dental health as part of the multidisciplinary care required for optimal CIF care.

背景:慢性肠功能衰竭(CIF)患者的口腔健康状况可能较差。本研究探讨了 CIF 成年患者自我报告的口腔健康状况、功能和口腔健康的心理影响,他们获得牙科护理的情况,以及这些情况与更广泛人群的比较:方法:邀请所有年龄大于 18 岁、接受家庭静脉注射疗法治疗 CIF 的患者填写一份自我报告问卷,提供有关口腔健康状况和获得口腔医疗服务的信息。辅助信息由主治临床医生提供。研究人员进行了描述性数据分析,包括临床特征的分组分析,并与现有的人群数据进行了比较:24名患者参与了研究。肠道短小和蠕动障碍占 CIF 病因的 88%。受访者报告了良好的口腔健康预防行为(96%),在过去 12 个月内接受过牙科治疗(75%),接受治疗的障碍有限。口干(96%)、口腔疼痛(59%)和温度敏感(60%)是受访者普遍报告的症状。吸烟史和口腔饮食减少与自我报告的口腔健康状况明显较差有关。与普通人群相比,CIF 患者尽管口腔卫生条件较好,但其口腔健康状况却较差:结论:CIF 患者似乎面临口腔健康状况较差的风险,尤其是在同时涉及吸烟或口腔摄入量减少的情况下。参与 CIF 护理的临床医生应警惕该人群的口腔健康需求,并将口腔和牙科健康视为最佳 CIF 护理所需的多学科护理的一部分。
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引用次数: 0
New randomized controlled trials on micronutrients in critical care nutrition: A narrative review. 关于重症监护营养中微量营养素的新随机对照试验:叙述性综述。
IF 2.1 4区 医学 Q3 NUTRITION & DIETETICS Pub Date : 2024-10-01 Epub Date: 2024-08-09 DOI: 10.1002/ncp.11195
Zakiah Halim, Yingxiao Huang, Zheng-Yii Lee, Charles Chin Han Lew

There has been increasing interest in the role of micronutrient supplementation in critical care. This narrative review summarizes the recent studies on micronutrients in critically ill patients. We searched two databases for primary randomized controlled trials that investigated the effects of micronutrient supplementation in patients with critical illness published from January 2021 to August 2023. Personal files, reference lists of included studies, and previous reviews were also screened. Twelve studies reported on vitamin C, four studies on vitamin D, three studies on thiamin, two studies on multivitamins, and one study on cobalamin. The therapeutic effects of vitamin C appear mixed, although vitamin C monotherapy appears more promising than vitamin C combination therapy. Intramuscular administration of vitamin D appeared to lower mortality, mechanical ventilation duration, and intensive care unit stay, whereas enteral administration showed limited clinical benefits. Intravenous thiamin was not associated with improved outcomes in patients with septic shock or hypophosphatemia. Preliminary evidence suggests reduced vasopressor dose with cobalamin. Decreased disease severity and hospital stay in patients with COVID-19 with vitamins A-E requires further investigation, whereas providing solely B-group vitamins did not demonstrate therapeutic effects. It is currently premature to endorse the provision of high-dose micronutrients in critical illness to improve clinical outcomes. This review may help to inform the design of future trials that will help better elucidate the optimal dosage and form of micronutrients, methods of administration, and subgroups of patients with critical illness who may most benefit.

人们越来越关注微量营养素补充剂在重症监护中的作用。本综述总结了近期有关重症患者微量营养素的研究。我们在两个数据库中检索了 2021 年 1 月至 2023 年 8 月间发表的研究危重症患者补充微量营养素效果的主要随机对照试验。此外,我们还筛选了个人档案、纳入研究的参考文献列表以及之前的综述。12 项研究报告了维生素 C,4 项研究报告了维生素 D,3 项研究报告了硫胺素,2 项研究报告了多种维生素,1 项研究报告了钴胺素。维生素 C 的治疗效果似乎好坏参半,但维生素 C 单一疗法似乎比维生素 C 综合疗法更有前景。肌肉注射维生素 D 似乎可以降低死亡率、机械通气时间和重症监护室住院时间,而肠内给药的临床疗效有限。静脉注射硫胺素并不能改善脓毒性休克或低磷血症患者的预后。初步证据表明,使用钴胺素可减少血管加压剂量。使用维生素 A-E 可降低 COVID-19 患者的疾病严重程度和住院时间,这还需要进一步研究,而只提供 B 族维生素并没有显示出治疗效果。目前认可在危重病人中提供大剂量微量营养素以改善临床效果还为时过早。本综述可为未来试验的设计提供参考,有助于更好地阐明微量营养素的最佳剂量和形式、给药方法以及最可能受益的危重症患者亚群。
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引用次数: 0
When to feed after percutaneous endoscopic gastrostomy: A systematic review and meta-analysis of randomized controlled trials. 经皮内镜胃造口术后何时进食?随机对照试验的系统回顾和荟萃分析。
IF 2.1 4区 医学 Q3 NUTRITION & DIETETICS Pub Date : 2024-10-01 Epub Date: 2024-07-07 DOI: 10.1002/ncp.11184
Matthew L Bechtold, Zahid Ijaz Tarar, Muhammad N Yousaf, Ghady Moafa, Abdul M Majzoub, Xheni Deda, Michelle L Matteson-Kome, Srinivas R Puli

Background: Initiation of feeding after percutaneous endoscopic gastrostomy (PEG) placement has been debated. Randomized controlled trials (RCTs) have been performed on early feeding compared with delayed feeding after PEG placement with varying results. Therefore, a meta-analysis was conducted examining early vs delayed feeding after placement of a PEG.

Methods: A comprehensive search of databases was conducted in January 2024. Peer-reviewed published RCTs comparing early feeding (≤4 h) with delayed feeding (>4 h) were identified and included in the meta-analysis. Meta-analysis was completed using pooled estimates of overall complications, individual complications, mortality ≤72 h, and number of day 1 significant gastric residual volumes.

Results: Six RCTs (n = 467) were included in the analysis. Comparison of early feeding with delayed feeding after PEG showed no statistically significant differences for overall complications (P = 0.18), mortality ≤72 h (P = 0.3), and number of day 1 significant gastric residual volumes (P = 0.05). No differences were also noted for individual complications, including vomiting, wound infection, bleeding, or diarrhea.

Conclusion: Feeding ≤4 h after PEG have no differences in minor and major complications compared with that of delayed feeding. Early feeding ≤4 h is safe and should be recommended in future guidelines.

背景:经皮内镜胃造口术(PEG)置管后开始喂食一直备受争议。已进行的随机对照试验(RCT)对置入 PEG 后早期喂养与延迟喂养进行了比较,结果各不相同。因此,我们对放置 PEG 后早期喂养与延迟喂养进行了荟萃分析:方法:2024 年 1 月对数据库进行了全面检索。方法: 2024 年 1 月对数据库进行了全面搜索,确定了经同行评审的已发表 RCT,这些 RCT 对早期喂养(≤4 小时)和延迟喂养(>4 小时)进行了比较,并纳入了荟萃分析。使用总体并发症、单个并发症、≤72 小时死亡率和第 1 天显著胃残留量的汇总估计值完成了荟萃分析:分析纳入了六项研究性临床试验(n = 467)。PEG术后早期喂养与延迟喂养的比较结果显示,在总体并发症(P = 0.18)、72小时以内死亡率(P = 0.3)和第1天显著胃残留量数量(P = 0.05)方面没有统计学差异。呕吐、伤口感染、出血或腹泻等个别并发症也无差异:结论:PEG术后≤4小时喂食与延迟喂食相比,在轻微和主要并发症方面没有差异。早期喂食≤4 小时是安全的,应在今后的指南中予以推荐。
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引用次数: 0
Response to "Utility of SARC-F for screening for sarcopenia in ulcerative colitis". 对 "SARC-F 在筛查溃疡性结肠炎患者肌少症方面的实用性 "的回应
IF 2.1 4区 医学 Q3 NUTRITION & DIETETICS Pub Date : 2024-10-01 Epub Date: 2024-06-30 DOI: 10.1002/ncp.11183
Ilkay Ergenc, Chasan Ismail Basa, Alper Uzum, Sevval Sahin, Haluk Tarık Kani, Rahmi Aslan, Aslı Tufan, Özgür Kasımay, Özlen Atuğ, Yeşim Özen Alahdab
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引用次数: 0
Implementation of standardized feeding pathways for infants with gastroschisis to improve patient outcomes: A quality improvement project in a level IV surgical NICU. 为患有胃裂的婴儿实施标准化喂养路径,以改善患者预后:四级手术新生儿重症监护室的质量改进项目。
IF 2.1 4区 医学 Q3 NUTRITION & DIETETICS Pub Date : 2024-09-25 DOI: 10.1002/ncp.11216
Andrea Adler, Kadakkal Radhakrishnan, Natalie Yeaney

Gastroschisis is a leading cause of pediatric intestinal failure. Feeding guidelines may lead to improved patient outcomes including decreased time to reach full feeds, a reduction in the duration of parenteral nutrition, and reduced length of stay. However, there is limited evidence on what the ideal feeding guidelines are for this complex gastrointestinal diagnosis. In this quality improvement project, after completing a literature review, we created three pathways based on the complexity of the gastroschisis. We reviewed historical data without a defined feeding pathway/guideline to our newly created pathways in the intervention group. The study included 35 patients with varying degrees of gastroschisis complexity, consisting of 9 current patients (October 2021-December 2022) who were provided with defined feeding pathways and 26 historical patients before the protocol was implemented (January 2015-August 2021). There were no significant differences in the number of days required for full feeds between the two groups. However, the mean duration of parenteral nutrition was 18.9 days (95% CI, -31.8 to -7.0) shorter in the intervention group. Although not statistically significant, the patients in the intervention group had a mean length of stay that was 13.1 days (95% CI, -50.0 to 25.4) shorter than the historical group. The creation of standardized feeding guidelines for the gastroschisis population resulted in a statistically nonsignificant decrease in time to reach full enteral feeds, a statistically significant reduced duration of parenteral nutrition, and a statistically nonsignifiant decreased length of stay.

胃裂是导致小儿肠道功能衰竭的主要原因。喂养指南可改善患者的治疗效果,包括缩短达到完全喂养的时间、缩短肠外营养的持续时间和缩短住院时间。然而,对于这种复杂的胃肠道疾病,理想的喂养指南是什么,目前证据还很有限。在这个质量改进项目中,在完成文献回顾后,我们根据胃裂的复杂程度创建了三种路径。我们回顾了干预组中没有明确喂养路径/指南的历史数据,以及我们新创建的路径。该研究纳入了35名具有不同程度胃裂复杂性的患者,其中包括9名目前(2021年10月至2022年12月)已获得明确喂养路径的患者和26名协议实施前(2015年1月至2021年8月)的历史患者。两组患者完全进食所需的天数没有明显差异。但是,干预组的肠外营养平均持续时间缩短了 18.9 天(95% CI,-31.8 到 -7.0)。干预组患者的平均住院时间比历史组缩短了 13.1 天(95% CI,-50.0 到 25.4),尽管没有统计学意义。为胃十二指肠畸形患者制定标准化喂养指南后,达到完全肠内喂养的时间在统计学上无显著性差异,肠外营养的持续时间在统计学上有显著性差异,住院时间在统计学上无显著性差异。
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引用次数: 0
Poor nutrition status associated with low patient satisfaction six months into treatment for head and neck/esophageal cancer treatment: A prospective multicenter cohort study. 营养状况差与头颈部/食管癌治疗六个月后患者满意度低有关:一项前瞻性多中心队列研究。
IF 2.1 4区 医学 Q3 NUTRITION & DIETETICS Pub Date : 2024-09-22 DOI: 10.1002/ncp.11211
Adrianne M Widaman, Andrew G Day, Maggie A Kuhn, Rupinder Dhaliwal, Vickie Baracos, Merran Findlay, Judith D Bauer, Marian de van der Schueren, Alessandro Laviano, Lisa Martin, Leah Gramlich

Background: Patient-reported outcome measures have been associated with survival in oncology patients. Altered intake and malnutrition are common symptoms for patients treated for head and neck cancer and esophageal cancer (HNC/EC). The purpose of this study was to examine the relationship between patient-reported satisfaction with medical care and nutrition status.

Methods: This prospective cohort study collected data from 11 international cancer care sites.

Results: One hundred and sixtythree adult patients (n = 115 HNC; n = 48 EC) completed a patient satisfaction questionnaire (the Canadian Health Care Evaluation Project Lite) and were included. HNC/EC patient global satisfaction with medical care was 88.3/100 ± 15.3 at baseline and remained high at 86.6/100 ± 16.8 by 6 months (100 max satisfaction score). Poor nutrition status, as defined by the Patient-Generated Subjective Global Assessment Short Form, was associated with lower patient satisfaction with overall medical care, relationship with doctors, illness management, communication, and decision-making 6 months into treatment (P < 0.01). There was no difference in global satisfaction between patients who did and did not report swallowing difficulty (P = 0.99) and patients with and without feeding tube placement (P = 0.36). Patients who were seen by a dietitian for at least one nutrition assessment had global satisfaction with care that was 16.7 percentage points higher than those with no nutrition assessment (89.3 ± 13.8 vs 72.6 ± 23.6; P = 0.005) CONCLUSION: In HNC/EC patient-centered oncology care, decreasing malnutrition risk and providing access to dietitian-led nutrition assessments should be prioritized and supported to improve patient satisfaction and standard of care. Feeding tube placement did not decrease patient satisfaction with medical care.

背景患者报告的结果测量与肿瘤患者的存活率有关。摄入量改变和营养不良是头颈癌和食管癌(HNC/EC)患者的常见症状。本研究旨在探讨患者报告的医疗护理满意度与营养状况之间的关系:这项前瞻性队列研究收集了来自 11 个国际癌症治疗机构的数据:163 名成年患者(n = 115 名 HNC;n = 48 名 EC)填写了患者满意度问卷(加拿大医疗保健评估项目简版),并被纳入研究。HNC/EC 患者对医疗护理的总体满意度在基线时为 88.3/100 ± 15.3,6 个月后保持在 86.6/100 ± 16.8 的高水平(最高满意度为 100 分)。根据患者主观全面评估简表(Patient-Generated Subjective Global Assessment Short Form)的定义,营养状况差与治疗 6 个月后患者对整体医疗护理、与医生的关系、疾病管理、沟通和决策的满意度较低有关(P<0.05)。
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引用次数: 0
Transforming the electronic health record from a documentation application to an automated diet program for personalizing neonatal nutrition and improving feeding administration safety through process improvement. 将电子病历从文档应用程序转变为自动饮食程序,通过改进流程实现新生儿营养个性化并提高喂养管理安全性。
IF 2.1 4区 医学 Q3 NUTRITION & DIETETICS Pub Date : 2024-09-22 DOI: 10.1002/ncp.11212
Alisha Harmeson Owen, Ameena Husain, David ElHalta, Suzie A Chen, Jennifer Spackman, Jennifer Murphy, Belinda Chan

Delivering adequate nutrition to preterm and sick neonates is critical for growth. Infants in the neonatal intensive care unit (NICU) require additional calories to supplement feedings for higher metabolic demands. Traditionally, clinicians enter free-text diet orders for a milk technician to formulate recipes, and dietitians manually calculate nutrition components to monitor growth. This daily process is complex and labor intensive with potential for error. Our goal was to develop an electronic health record (EHR)-integrated solution for entering feeding orders with automated nutrition calculations and mixing instructions. The EHR-integrated automated diet program (ADP) was created and implemented at a 52-bed level III academic NICU. The configuration of the parenteral nutrition orderable item within the EHR was adapted to generate personalized milk mixing recipes. Caloric, macronutrient, and micronutrient constituents were automatically calculated and displayed. To enhance administration safety, handwritten milk bottle patient labels were substituted with electronically generated and scannable patient labels. The program was further enhanced by calculating fortifier powder displacement factors to improve mixing precision. Order entry was optimized to allow for more complex mixing recipes and include a preference list of frequently ordered feeds. The EHR-ADP's safeguarded features allowed for catching multiple near-missed feeding administration errors. The NICU preterm neonate cohort had an average of 6-day decrease (P = 0.01) in the length of stay after implementation while maintaining the same weight gain velocity. The EHR-ADP may improve safety and efficiency; further improvements and wider utilization are needed to demonstrate the growth benefits of personalized nutrition.

为早产儿和患病新生儿提供充足的营养对其生长至关重要。新生儿重症监护室(NICU)中的婴儿需要额外的热量来补充喂养,以满足更高的新陈代谢需求。传统上,临床医生输入自由文本的饮食指令,由乳品技术员制定食谱,营养师手动计算营养成分以监测生长。这样的日常工作既复杂又耗费人力,还可能出错。我们的目标是开发一种集成电子健康记录 (EHR) 的解决方案,用于输入带有自动营养计算和混合说明的喂养指令。我们在一家拥有 52 张床位的三级学术重症监护病房创建并实施了电子病历集成自动饮食程序 (ADP)。电子病历中肠外营养订单项目的配置经调整后可生成个性化的牛奶混合配方。热量、宏量营养素和微量营养素成分会自动计算并显示。为提高用药安全,用电子生成的可扫描病人标签取代了手写的奶瓶病人标签。通过计算营养强化剂粉末置换系数来提高混合精度,进一步增强了程序的功能。订单输入经过优化,可以输入更复杂的混合配方,并包含一份经常订购饲料的偏好列表。EHR-ADP 的保护功能可捕捉到多个差点遗漏的喂养管理错误。新生儿重症监护室早产新生儿队列在实施该系统后,住院时间平均缩短了 6 天(P = 0.01),同时体重增长速度保持不变。电子病历-ADP可提高安全性和效率;要证明个性化营养对成长的益处,还需要进一步的改进和更广泛的应用。
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引用次数: 0
Measurement of mid‐upper arm circumference to screen for childhood malnutrition: General applicability and use in special populations 测量中上臂围以筛查儿童营养不良:一般适用性和在特殊人群中的使用
IF 3.1 4区 医学 Q3 NUTRITION & DIETETICS Pub Date : 2024-09-18 DOI: 10.1002/ncp.11208
Patricia Becker, Susan Abdel‐Rahman, Dan Nemet, Luise V. Marino, Garey Noritz, Mauro Fisberg, Kaitlan Beretich
Since the development of consensus‐recommended indicators for pediatric malnutrition in 2014, screening and diagnosis of pediatric malnutrition have improved, but the indicators are not always used; malnutrition continues to be underdiagnosed in some community and healthcare settings. In particular, mid‐upper arm circumference (MUAC) is underused as a screening indicator for pediatric malnutrition, despite its unique advantages and usefulness in several clinical situations. In December 2022, a scientific roundtable was held to bring together several experts in pediatric malnutrition. One of the goals of the scientific roundtable was to discuss the clinical use of anthropometric measures as screening tools for pediatric malnutrition status, with a focus on the use of MUAC. This article arose from that event and is intended as an educational tool to aid clinicians in implementing MUAC measurements. In addition to describing the use of MUAC as a screening tool, the article discusses several clinical situations in which MUAC is especially useful. Additionally, the article reviews practical aspects of measuring and interpreting MUAC values, provides links to additional educational resources, and briefly reviews areas in which further research is needed regarding the use of MUAC for screening of nutrition status in children.
自2014年制定了共识推荐的儿科营养不良指标以来,儿科营养不良的筛查和诊断得到了改善,但这些指标并不总是被使用;在一些社区和医疗机构中,营养不良的诊断仍然不足。尤其是中上臂围(MUAC),尽管它具有独特的优势,在一些临床情况下非常有用,但作为儿科营养不良的筛查指标却未得到充分利用。2022 年 12 月,儿科营养不良方面的多位专家举行了一次科学圆桌会议。科学圆桌会议的目标之一是讨论将人体测量指标作为儿科营养不良状况筛查工具在临床中的应用,重点关注MUAC的使用。本文即源于此次活动,旨在作为一种教育工具,帮助临床医生实施 MUAC 测量。除了介绍将 MUAC 用作筛查工具外,文章还讨论了 MUAC 特别有用的几种临床情况。此外,文章还回顾了测量和解释 MUAC 值的实用方面,提供了其他教育资源的链接,并简要回顾了在使用 MUAC 筛查儿童营养状况方面需要进一步研究的领域。
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