RESUMO
Objective To investigate the nutritional status of children with mechanical ventilation, explore the influencing factors of nutritional status,and provide a basis for clinical nutrition support for chil-dren with mechanical ventilation. Methods The children with mechanical ventilation who had ventilated for more than 5 days during the period from February 1,2017 to October 31,2017 were selected as subjects. Ac-cording to the mechanical ventilation time,they were divided into group A (5-16 d) and group B (17-29 d). We assessed malnutrition,screened nutritional risk,and measured albumin both on the admission and with-drawal of the ventilator, respectively. We also calculated the average caloric intake value (EI) and fluid vol-ume during mechanical ventilation. Measured resting energy expenditure (MREE)was calculated by using the Schofield-HTWT formula. Feeding status during mechanical ventilation was assessed by average EI/MREE. Results The incidence of malnutrition at admission was 36. 1%(13/36),and the incidence of malnutrition was 55. 6%(20/36) when evacuated from the ventilator. There was a significant difference(P<0. 05). The incidence of malnutrition was similar in group A and group B on admission,but the incidence of malnutrition in group B(62. 5%) was significantly higher than that in group A (53. 6%) when weaning. The average cal-orie in group B[(32. 25 ± 7. 36)kcal/(kg·d)]was significantly lower than that in group A[(40. 11 ± 6. 00) kcal/(kg·d)]. The mechanical ventilation time of group B[(540. 63 ± 89. 66) h] was significantly longer than that of group A[(224. 46 ± 64. 06)h](P<0. 05). Conclusion Children with mechanical ventilation in the PICU have a higher incidence of malnutrition and the nutritional status deteriorates further during hospital-ization,which may be related to calorie supply,duration of mechanical ventilation,fluid volume,and primary disease.
RESUMO
Objective To investigate the development and application of blood purification in PICU. Methods The demographic data,diagnosis,length of stay,prognosis,patterns and frequency of blood purifi-cation and complications of PICU patients treated with blood purification in our hospital from 2010 to 2017 were retrospectively analyzed. Results The patients with blood purification accounted for 3. 1％ of hospital-ized children in the same period. From 2010 to 2017,the patients and times with blood purification increased by 370. 6％ and 398. 3％ respectively. The times of continuous veno-venous hemodiafiltration(CVVHDF), plasma exchange and hemoperfusion increased by 135. 2％,6300％ and 1600％ respectively. The frequency of CVVHDF,plasma exchange and hemoperfusion accounted for 42. 8％(492/1151),33. 5％(386/1151), and 23. 7％ (273/1151) respectively. Drug and toxic poision accounted for the highest proportion of 28. 6％(81/284),neurological diseases accounted for 20. 8％(59/284),sepsis with multiple organ dysfunction syn-drome accounted for 18. 0％( 51/284 ) , digestive system diseases, autoimmune diseases, renal diseases and metabolic diseases accounted for 14. 4％( 41/284 ) ,4. 9％( 14/284 ) ,4. 9％ ( 14/284 ) and 4. 2％( 12/284 ) respectively. The cure rate was 63. 8％. Complication included thrombus. Conclusion Blood purification has become the preferred modality for the management of critically ill children. Pediatric blood purification tech-niques have developed rapidly in our PICU and domestic pediatric. Further specification is required,so that it may represent the adequate choice for critical ill children.
RESUMO
Malnutrition has a high incidence in PICU children,which is closely related to the progression of disease and the prognosis of critically ill children.Nutritional support therapy is of great significance to critical ill children in PICU,which can improve the general nutritional status and immune status of children,and affect clinical prognosis.Different nutritional status (underfeeding,adequate feeding,overfeeding) on the nutritional status of children and the prognosis of disease is different.