Enteral nutrition support for children with surgical pathology over the periooperative period
https://doi.org/10.46563/1560-9561-2023-26-3-168-177
EDN: vygdfh
Abstract
Introduction. The results of treatment of children who are preparing or have already undergone major surgery depend on many factors, including the nutritional status — the presence/absence of malnutrition.
Aim: to assess the nutritional risk and nutritional status in children with surgical diseases during pre- and postoperative periods.
Materials and methods. A prospective, single-center, non-comparative study included 60 children aged from 1 month to 17.5 years with diseases of the esophagus, intestines, urogenital system, admitted for surgical treatment. In all patients, the anamnestic data of life and disease were analyzed, screening of nutritional risk was assessed according to the validated Russian version of the STRONG-kids screening tool, nutritional status was evaluated using the WHO AnthroPlus program (2009) and the anthropometric indices (Z-scores: weight/age, height/age, BMI/age), the biochemical parameters (concentrations of C-reactive protein, total protein, albumin, prealbumin, transferrin) were estimated.
Results. A high nutritional risk at admission was established in more than half (57%) of patients, moderate — in 36% of patients, low — only in 7% of cases. Malnutrition (Z-score BMI/age from –1 to –3) was diagnosed in 24 (40%) patients, 58% of them suffered from diseases of the esophagus, 37% had pathology of the intestine and 36% — the genitourinary system.
Conclusion. Nutritional risk screening and nutrition status assessment are necessary in all patients admitted to pediatric surgical hospitals for the timely appointment of adequate nutritional support, which will reduce the incidence of postoperative complications and decreasing the length of hospital stay.
Contribution:
Borovik Т.Е., Yatsyk S.P., Alkhasov A.B. — research concept and design of the study;
Fomina М.V., Gusev А.А., Guseva I.M. — collection and processing of material;
Sokolov I., Bushueva T.V. — statistical processing;
Borovik Т.Е., Yatsyk S.P., Zvonkova N.G. — text writing;
Fisenko A.P., Zvonkova N.G., Bushueva T.V. — editing.
All co-authors — approval of the final version of the article, responsibility for the integrity of all part of the article.
Acknowledgment. The study had no sponsorship.
Conflict of interest. The authors declare no conflict of interest.
Received: April 11, 2023
Accepted: May 16, 2023
Published: June 27, 2023
About the Authors
Tatiana E. BorovikRussian Federation
D. Sci. (Med.), Prof., Head of Healthy and sick child nutrition laboratory, National Medical Research Center for Children’s Health of the Ministry of Health of the Russian Federation; prof. of the Department of Pediatrics and Pediatric Rheumatology I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
e-mail: nutrborovik@mail.ru
Мaria V. Fomina
Russian Federation
Sergey P. Yatsyk
Russian Federation
Tatyana V. Bushueva
Russian Federation
Nataliya G. Zvonkova
Russian Federation
Аleksey А. Gusev
Russian Federation
Vera A. Skvortsova
Russian Federation
Ina Sokolov
Russian Federation
Irina M. Guseva
Russian Federation
Andrey P. Fisenko
Russian Federation
Abdumanap B. Alkhasov
Russian Federation
References
1. Borovik T.E., Ladodo K.S., eds. Clinical Dietetics of Childhood [Klinicheskaya dietologiya detskogo vozrasta, rukovodstvo dlya vrachey]. Moscow: MIA; 2015. (in Russian)
2. Leyderman I.N., Gritsan A.I., Zabolotskikh I.B., Mazurok V.A., Polyakov I.V., Potapov A.L., et al. Perioperative nutritional support. Vestnik intensivnoy terapii imeni A.I. Saltanova. 2021; (4): 7–20. (in Russian)
3. Weimann A., Braga M., Carli F., Higashiguchi T., Hübner M., Klek S., et al. ESPEN practical guideline: Clinical nutrition in surgery. Clin. Nutr. 2021; 40(7): 4745–1. https://doi.org/10.1016/j.clnu.2021.03.031
4. Wobith M., Weimann A. Oral nutritional supplements and enteral nutrition in patients with gastrointestinal surgery. Nutrients. 2021; 13(8): 2655. https://doi.org/10.3390/nu13082655
5. Lobo D.N., Gianotti L., Adiamah A., Barazzoni R., Deutz N.E.P., Dhatariya K., et al. Perioperative nutrition: Recommendations from the ESPEN expert group. Clin. Nutr. 2020; 39(11): 3211–27. https://doi.org/10.1016/j.clnu.2020.03.038
6. Whittle J., Wischmeyer P.E., Grocott M.P.W., Miller T.E. Surgical prehabilitation: nutrition and exercise. Anesthesiol. Clin. 2018; 36(4): 567–80. https://doi.org/10.1016/j.anclin.2018.07.013
7. Evdokimova T.A., Sorvacheva T.N., Volkova L.Yu., Safronova A.N., Petryaykina E.E. Farmateka. 2020; 27(1): 33–9. https://doi.org/10.18565/pharmateca.2020.1.33-38 https://elibrary.ru/zgteen. (in Russian)
8. Matarese L.E., Harvin G. Nutritional care for patients with intestinal failure. Gastroenterol. Clin. North Am. 2021; 50(1): 201–16. https://doi.org/10.1016/j.gtc.2020.10.004
9. Dresen E., Naidoo O., Hill A., Elke G., Lindner M., Jonckheer J., et al. Medical nutrition therapy in patients receiving ECMO: Evidence-based guidance for clinical practice. JPEN J. Parenter. Enteral. Nutr. 2023; 47(2): 220–35. https://doi.org/10.1002/jpen.2467
10. Schuetz P., Fehr R., Baechli V., Geiser M., Deiss M., Gomes F., et al. Individualised nutritional support in medical inpatients at nutritional risk: a randomised clinical trial. Lancet. 2019; 393(10188): 2312–21. https://doi.org/10.1016/S0140-6736(18)32776-4
11. Fisenko A.P., Borovik T.E., Bushueva T.V., Gusev A.A., Zvonkova N.G., Lebedeva M., et al. Optimization of Nutritional Support in the Complex Treatment of Children with Surgical Pathology [Optimizatsiya nutritivnoy podderzhki v kompleksnom lechenii detey s khirurgicheskoy patologiey]. Moscow: MIA-Press; 2022. (in Russian)
12. Pash E. Enteral nutrition: options for short-term access. Nutr. Clin. Pract. 2018; 33(2): 170–6. https://doi.org /10.1002/ncp.10007
13. Kharitonova A.Yu., Smirnov I.E., Shavrov A.A., Kalashnikova N.A. Narrow-band imaging endoscopy in the diagnosis of destructive changes in the mucous membrane of the stomach and duodenum in children. Rossiyskiy pediatricheskiy zhurnal. 2012; 15(6): 20–4. https://elibrary.ru/punhez (in Russian)
14. Poddubnyy I.V., Syt’kov V.V., Smirnov I.E., Vorob’eva Yu.D., Tolstov K.N. Modern methods for diagnosing pathology of the cardio-esophageal transition in children. Rossiyskiy pediatricheskiy zhurnal. 2020; 23(1): 42–7. https://doi.org/10.18821/1560-9561-2020-23-1-42-47 https://elibrary.ru/wtnrwf (in Russian)
15. Zvonkova N.G., Borovik T.E., Chernikov V.V., Gemdzhyan E.G., Yatsyk S.P., Fisenko A.P., et al. Adaptation and validation of the Russian version of the STRONG kids questionnaire to assess nutritional risk in children. Pediatriya. Zhurnal im. G.N. Speranskogo. 2022; 101(4): 156–64. https://doi.org/10.24110/0031-403X-2022-101-4-155-164 (in Russian)
16. WHO. AnthroPlus for personal computers. Manual: Software for assessing growth of the world’s children and adolescents. Geneva; 2009. Available at: https://www.who.int/growthref/tools/en/
17. Lyashchenko Yu.N. Enteral nutrition: history, current state and prospects of development. Klinicheskoe pitanie. 2004; (3): 20–5. (in Russian)
18. Tutel’yan V.A., Nikityuk D.B., Pogozheva A.V., eds. Nutritionology and Clinical Dietetics [Nutritsiologiya i klinicheskaya dietologiya]. Moscow; 2023. (in Russian)
19. Petrikov S.S., Khubutiya M.Sh., Popova T.S., eds. Parenteral and Enteral Nutrition [Parenteral’noe i enteral’noe pitanie]. Moscow; 2023. (in Russian)
20. Syt’kov V.V., Borovik T.E., Smirnov I.E., Poddubnyy I.V. Changes in microbiota and peculiarities of the use of probiotics for the prevention of complications of the surgical treatment of Hirschsprung disease in children. Rossiyskiy pediatricheskiy zhurnal. 2017; 20(3): 172–9. https://doi.org/10.18821/1560-9561-2017-20(3)-172-179 https://elibrary.ru/yuivkb (in Russian)
21. Puzio T.J., Kozar R.A. Nutrition in the critically ill surgical patient. Curr. Opin. Crit. Care. 2020; 26(6): 622–7. https://doi.org/10.1097/MCC.0000000000000764
22. Martínez-Ortega A.J., Piñar-Gutiérrez A., Serrano-Aguayo P., González-Navarro I., Remón-Ruíz P.J., Pereira-Cunill J.L., et al. Perioperative nutritional support: a review of current literature. Nutrients. 2022; 14(8): 1601. https://doi.org/10.3390/nu14081601
23. Lakananurak N., Gramlich L. The role of preoperative parenteral nutrition. Nutrients. 2020; 12(5): 1320. https://doi.org/10.3390/nu12051320
24. Luft V.M., Lapitskiy A.V., Borovik T.E., Bushueva T.V., Sergeeva A.M. Handbook of Clinical Nutrition [Spravochnik po klinicheskomu pitaniyu]. St. Petersburg: RA Russkiy Yuvelir; 2021. (in Russian)
Review
For citations:
Borovik T.E., Fomina М.V., Yatsyk S.P., Bushueva T.V., Zvonkova N.G., Gusev А.А., Skvortsova V.A., Sokolov I., Guseva I.M., Fisenko A.P., Alkhasov A.B. Enteral nutrition support for children with surgical pathology over the periooperative period. Russian Pediatric Journal. 2023;26(3):168-177. (In Russ.) https://doi.org/10.46563/1560-9561-2023-26-3-168-177. EDN: vygdfh