PMID- 18568246
OWN - NLM
STAT- MEDLINE
DCOM- 20090716
LR  - 20220629
IS  - 1807-5932 (Print)
IS  - 1980-5322 (Electronic)
IS  - 1807-5932 (Linking)
VI  - 63
IP  - 3
DP  - 2008 Jun
TI  - Hospital malnutrition and inflammatory response in critically ill children and 
      adolescents admitted to a tertiary intensive care unit.
PG  - 357-62
AB  - Critical illness has a major impact on the nutritional status of both children 
      and adults. A retrospective study was conducted to evaluate the incidence of 
      hospital malnutrition at a pediatric tertiary intensive care unit (PICU). Serum 
      concentrations of IL-6 in subgroups of well-nourished and malnourished patients 
      were also evaluated in an attempt to identify those with a potential nutritional 
      risk. METHODS: A total of 1077 patients were enrolled. Nutritional status was 
      evaluated by Z-score (weight for age). We compared mortality, sepsis incidence, 
      and length of hospital stay for nourished and malnourished patients. We had a 
      subgroup of 15 patients with severe malnutrition (MN) and another with 14 
      well-nourished patients (WN). Cytokine IL-6 determinations were performed by 
      enzyme-linked immunosorbent assay. RESULTS: 53% of patients were classified with 
      moderate or severe malnutrition. Similar amounts of C- reactive protein (CRP) 
      were observed in WN and MN patients. Both groups were able to increase IL-6 
      concentrations in response to inflammatory systemic response and the levels 
      followed a similar evolution during the study. However, the mean values of serum 
      IL-6 were significantly different between WN and MN patients across time, 
      throughout the study (p = 0.043). DISCUSSION: a considerable proportion of 
      malnourished patients need specialized nutritional therapy during an intensive 
      care unit (ICU) stay. Malnutrition in children remains largely unrecognized by 
      healthcare workers on admission. CONCLUSIONS: The incidence of malnutrition was 
      very high. Malnourished patients maintain the capacity to release inflammatory 
      markers such as CRP and IL-6, which can be considered favorable for combating 
      infections On the other hand, this capacity might also have a significant impact 
      on nutritional status during hospitalization.
FAU - Delgado, Artur F
AU  - Delgado AF
AD  - Unidade de Terapia Intensiva, Instituto da Crianca Prof Pedro de Alcantara, 
      Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil. 
      arturdf@terra.com.br
FAU - Okay, Thelma S
AU  - Okay TS
FAU - Leone, Claudio
AU  - Leone C
FAU - Nichols, Buford
AU  - Nichols B
FAU - Del Negro, Gilda Maria
AU  - Del Negro GM
FAU - Vaz, Flavio Adolfo Costa
AU  - Vaz FA
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Clinics (Sao Paulo)
JT  - Clinics (Sao Paulo, Brazil)
JID - 101244734
RN  - 0 (Biomarkers)
RN  - 0 (Interleukin-6)
RN  - 9007-41-4 (C-Reactive Protein)
SB  - IM
MH  - Adolescent
MH  - Biomarkers/blood
MH  - C-Reactive Protein/analysis
MH  - Child
MH  - Child, Preschool
MH  - Critical Illness/*epidemiology
MH  - Enzyme-Linked Immunosorbent Assay
MH  - Humans
MH  - Incidence
MH  - Intensive Care Units, Pediatric/*statistics & numerical data
MH  - Interleukin-6/*blood
MH  - Length of Stay
MH  - Malnutrition/blood/*epidemiology
MH  - Nutritional Status/physiology
MH  - Retrospective Studies
MH  - Sepsis/epidemiology
MH  - Severity of Illness Index
MH  - Time Factors
PMC - PMC2664228
EDAT- 2008/06/24 09:00
MHDA- 2009/07/17 09:00
PMCR- 2008/06/01
CRDT- 2008/06/24 09:00
PHST- 2007/12/29 00:00 [received]
PHST- 2008/03/24 00:00 [accepted]
PHST- 2008/06/24 09:00 [pubmed]
PHST- 2009/07/17 09:00 [medline]
PHST- 2008/06/24 09:00 [entrez]
PHST- 2008/06/01 00:00 [pmc-release]
AID - S1807-5932(22)02798-3 [pii]
AID - cln63_3p0357 [pii]
AID - 10.1590/s1807-59322008000300012 [doi]
PST - ppublish
SO  - Clinics (Sao Paulo). 2008 Jun;63(3):357-62. doi: 10.1590/s1807-59322008000300012.