How to Cite
Abstract
NUTRITIONAL SUPPORT OF PALLIATIVE CHILDREN WITH SERIOUS NUTRIRION DEFICIT
T. Kurilina, T. Marushko, A. Pysariev, R. Loboda, I. Shurygina, K. Mashurenko
Children with severe injury of nervous system compose high risk group on nutrition deficit. The purpose of the study is to assess the degree of nutrition deficit, calculate its actual requirement in enteric substrate and organization of adequate feeding. Indices of Broke 2, Pine, Z-score were used for determination of nutrition insufficiency degree. Physiological and actual requirements were defined by Schofield (WН) equation. Broke 2 index accounted for 40 %, BWI – 9.18, Z-score for BW on age – "-"6, for height on age – "-"12, for BW on height – "-3.5", which attested about extreme degree of nutritive insufficient (cachexia) and significant delay in physical development. High requirements in energy and low tolerance for necessary volume of feeding determine the administration of specialized isocaloric clinical product. Conclusion. Employment of simple standardized indices allows to determine the degree of nutrition deficit in palliative children. The definition of actual, instead physiological, requirements and administration of special clinical products permits to provide adequate nutrition in spite of low tolerance for high volume of feeding.
Keywords: children, palliative care, nutrition’s deficit, clinical feeding, polymeric enteral products
НУТРИТИВНА ПІДТРИМКА ДІТЕЙ ПАЛІАТИВНОЇ ГРУПИ З ТЯЖКИМ НУТРИТИВНИМ ДЕФІЦИТОМ
Куріліна Т.В., Марушко Т.В., Писарєв А.О., Лобода Р.Н., Шуригіна І.В., Машуренко К.Ю.
Діти з тяжкими ураженнями нервової системи складають групу високого ризику по нутритивному дефіциту. Мета дослідження - оцінка ступеня нутритивного дефіциту у дитини паліативної групи, розрахунок її фактичних потреб у ентеральному субстраті та організація адекватного харчування. Матеріали і методи. Для визначення ступеня нутритивної недостатності використовували індекс Брока, індекс Пін’є, Z-score. Проведено обчислення фізіологічних та фактичних енергетичних потреб за рівнянням Schofield (WН). Результати: значення індексу Брока 2 у дитини становило 40 %, ІМТ – 9,18, Z-score для маси тіла на вік – "-"6, Z-score для росту на вік – "-"12, Z-score для маси тіла на довжину тіла – "-3,5", що свідчить про крайній ступінь нутритивної недостатності (кахексія) та значне відставання у фізичному розвитку. Високі енергетичні фактичні потреби та низька толерантність до потрібних об’ємів годування обумовили призначення спеціалізованого ізокалорійного клінічного харчування. Висновки. Застосування простих стандартизованих індексів дозволяє визначити ступінь нутритивного дефіциту у дітей паліативної групи. Визначення фактичних, замість фізіологічних потреб, а також застосування продуктів спеціалізованого клінічного харчування дозволяє забезпечити адекватне харчування, незважаючи на низьку толерантність до високих об’ємів їжі.
Ключові слова: діти, паліативна допомога, нутритивний дефіцит, клінічне харчування, полімерні ентеральні субстрати
НУТРИТИВНАЯ ПОДДЕРЖКА ДЕТЕЙ ПАЛЛИАТИВНОЙ ГРУППЫ С ТЯЖЕЛЫМ НУТРИТИВНЫМ ДЕФИЦИТОМ
Т.В. Курилина, Т.В. Марушко, А.А. Писарев, Р.Н. Лобода, И.В. Шурыгина, Е.Ю. Машуренко
Дети с тяжелыми повреждениями нервной системы составляют группу высокого риска по нутритивному дефициту. Цель исследования – оценка степени нутритивного дефицита у ребенка паллиативной группы, расчет ее фактических потребностей в энтеральном субстрате и организация адекватного вскармливания. Материал и методы. Для определения степени нутритивной недостаточности использовали индекс Брока 2, индекс Пинье, Z-score. По уравнению Schofield (WН) определены физиологические и фактические потребности. Результаты: индекс Брока 2 составил 40 %, ИМТ – 9,18, Z-score для массы тела на возраст – "-"6, для роста на возраст – "-"12, для массы тела на рост – "-3,5", что свидетельствует о крайней степени нутритивной недостаточности (кахексия) и значительное отставание в физическом развитии. Высокие энергетические потребности и низкая толерантность к нужным объемам кормления обусловили назначение специализированного изокалорийного клинического питания. Выводы. Использование простых стандартизированных индексов позволяет определить степень нутритивного дефицита у детей паллиативной группы. Определение фактических, вместо физиологических потребностей, а также использование специализированных продуктов клинического питания позволяет обеспечить адекватное питание, несмотря на низкую толерантность к высоким объемам питания.
Ключевые слова: дети, паллиативная помощь, нутритивный дефицит, клиническое питание, полимерные энтеральные субстраты.
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