Article Text

HOW TO DETECT THE MALNOURISHED CHILD ON ADMISSION TO THE PAEDIATRIC INTENSIVE CARE UNIT
  1. M E Augustus1,
  2. J M Hulst1,
  3. K F M Joosten1
  1. 1Intensive Care Children Unit, Erasmus MC, Sophia, Rotterdam, The Netherlands

Abstract

Aim To determine the prevalence of malnutrition in children admitted to paediatric intensive care units (PICU) using different anthropometric variables at admission and to correlate these variables. To associate length of hospital stay with nutritional status at admission.

Patients and Methods During a 2-month period all children admitted to the PICU were screened upon admission and at discharge (admitted >5 days), by measuring weight, mid-upper arm circumference (MUAC) and calf circumference (CC). Malnutrition was defined as an SD score for weight for age <–2.

Results 82 children (48 male) were studied with a median age of 3.1 years (range 0.04–20.47). Weight measurements were done in 40% and MUAC/CC were done in 70% of the children. Malnutrition was present in 32% of children, of whom 92% had an underlying disease. At discharge the prevalence of malnutrition was 36%. An SD score <−2 for MUAC and CC was found in 20% and 32% of the children, respectively. The mean length of stay in children with a MUAC <−2 SD was 7.6 days compared with 4.8 days in those with a MUAC >−2 SD.

Conclusion The prevalence of malnutrition on admission and at discharge is high. It is easier to perform measurements of MUAC or CC on admission, whereas it is difficult to obtain weight. The MUAC and CC might be used in the PICU to detect malnutrition. The relation between malnutrition on admission and length of hospital stay underlines the need for extra attention to the patient’s nutritional status during admission.

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