Hospital Malnutrition

According to worldwide studies, the prevalence of malnutrition among hospitalized patients has been reported to be about 15% to 60%. Hospital malnutrition is related to a high incidence of morbidity and mortality. It is often associated with impaired immunity, a high risk of infectious complications, delayed wound healing after surgery. Complications caused by hospital malnutrition consequently increase the length of hospital stay and total medical costs. It also affects the cost of rehabilitation and other individual and social health care costs. The prevalence of hospital malnutrition has encouraged nutritional support teams to become an integral part of the health care system to improve patient outcome. Collaboration between doctors, dieticians, pharmacists, and nurses specialized in nutrition are therefore vital to this initiative.

How to Manage the Pediatric Nutritional Support Team: Updates / 대한소아소화기영양학회지

Pediatric patients in hospital are at risk of malnutrition at admission and even during their hospitalization. Although the concept of nutritional support team (NST) was introduced to hospitals for optimal nutritional care since 1960s and the benefits of pediatric NST have been proven by many studies and reports in terms of patient clinical outcome and cost saving, the pediatric NST is not widespread yet. The pediatric NST composed of pediatricians, dieticians, pharmacist, and nutrition support nurses as core members dedicated to nutritional care in children should be independent of central NST or other disciplines, but closely cooperate with other teams in hospitals. There is no doubt that a multidisciplinary NST is an effective way to provide appropriate nutritional support to an individual patient. Therefore, the implementation of the pediatric NST in hospitals should be recommended to provide optimum nutritional support including enteral tube feeding and parenteral nutrition and to assess pediatric patients at risk of malnutrition.

Clinical Significance of the Nutritional Support Team for Preterm Infants in a Neonatal Intensive Care Unit / 대한소아소화기영양학회지

PURPOSE: Preterm infants are very susceptible to malnutrition because of a lack of storage of nutrients, immature digestion and metabolism, and accompanying diseases associated with prematurity. The purpose of this study was to evaluate the effects of nutritional support by the pediatric nutritional support team (pNST) on the clinical course of preterm infants in the neonatal intensive care unit (NICU). METHODS: Between July 2003 and July 2006, 48 preterm infants who were admitted to the NICU at Seoul National University Bundang Hospital were included. The subjects were divided into the following two subgroups according to the presence of NST activity; pre-NST group (n=23) and NST group (n=25). Hospital records were reviewed retrospectively. RESULTS: Forty-eight preterm babies were included (M:F=27:21; gestational age, 25~33 weeks). A dietician, pharmacists, or the pNST participated in the prescription of total parenteral nutrition (TPN) more rapidly in the NST group (p=0.000). The fasting periods and TPN administration periods were significantly decreased in the NST group compared to the pre-NST group (p=0.017 & p=0.001, respectively). The doses of calories, protein, and lipids administered via TPN were significantly increased in the NST group compared to the pre-NST group (p=0.016, p=0.000, and p=0.000, respectively). The total period on antibiotic therapy was significantly decreased in the NST group compared to the pre-NST group (p=0.007). CONCLUSION: Because nutritional support by the pNST is of benefit to the clinical course of preterm infants in the NICU, the pNST should recommend to improve the nutritional status and clinical outcome of preterm infants.

Managing Pediatric Nutritional Support Team in Hospital / 대한소아소화기영양학회지

Nutritional support team (NST) is a multidisciplinary group of nutrition professionals with interest and expertise in the evaluation and management of malnutrition and nutrition-related problems in hospital. The goal of NST is providing optimal nutrition to patients who need enteral and parenteral nutrition. Recently, NST is set up in some hospitals in Korea. However, until now, pediatric NST is not established in most hospitals. Because children admitted to hospital are at risk of malnutrition, NST is required to provide effective nutritional management for pediatric patients.