Screening and Nutritional Assessment of Critically ILL Children in PICU Ain Shams University

Abstract

Nutrition deficiency is common among hospitalized children. Although nutrition support in the form of enteral or parenteral nutrition may improve malnutrition in this population, the benefits of each form and the difference between forms of nutrition associated with their use have not yet been fully explored. Objective: to evaluate the anthropometric measurement and laboratory assessment especially albumin and Prealbumin in critically ill children in Ain Shams University Pediatric Hospital PICU, on admission and at discharge. Patients and Methods: Prospective study done on 30 patients admitted to PICU of Ain Shams University during period of six months, all patients aged from 30 days till 18 years old admitted during this period were included in this study. Anthropometric Measurements of all patients and lab parameters such as hemoglobin level, CRP, albumin, and Prealbumin measured at time of admission and repeated at discharge. Results: The present study showed that the Pediatric Index of Mortality (PIM-2) was high in non-survivors patients than survivors. Regarding the anthropometric measurements, our study showed there was a decrease of weight in non more than survivor more than survivors during discharge and decrease BMI at discharge, regarding route of feeding during admission in survivors patients: oral(15 (68.2%)) parenteral (3 (13.6%)) or Ryle(4 (18.2%)) versus non-survivors patients enteral (0 (0.0%)), parenteral(8 (100.0%)) ,and Ryle(0 (0.0%)). The early initiation of feeding on admission increases survival in patients and the results were (6.27±3.61) days in survivors and (8.13±2.42) days in non-survivors patients. There was a significant correlation between frequencies of feeding on admission which was shorter in survivors than non-survivors. The mean hemoglobin level in survivors’ patients (9.94±1.53) on admission and on discharge (10.22±0.61) and in non-survivors patients the mean level was on admission (Hb 10.22±0.61) and on. The albumin and Pre-albumin level on admission was significantly higher in survivors (albumin 3.19±0.57, Pre-albumin 945.45±446.12) than non-survivors patients (albumin 2.38±0.66, Pre-albumin 622.50±214.26).