Sigrid Bairdain1, Faraz A Khan1, Jeremy Fisher1, David Zurakowski2, Katelyn Ariagno3, Ryan P Cauley1, Jill Zalieckas1, Jay M Wilson1, Tom Jaksic1, Nilesh M Mehta4. 1. Department of Pediatric Surgery, Boston Children's Hospital, and Harvard Medical School, Boston, MA, United States. 2. Department of Pediatric Surgery, Boston Children's Hospital, and Harvard Medical School, Boston, MA, United States; Department of Anesthesiology, Perioperative & Pain Medicine, Boston Children's Hospital, and Harvard Medical School, Boston, MA, United States. 3. Division of Gastroenterology and Nutrition, Boston Children's Hospital, and Harvard Medical School, Boston, MA, United States. 4. Department of Anesthesiology, Perioperative & Pain Medicine, Boston Children's Hospital, and Harvard Medical School, Boston, MA, United States; Division of Critical Care Medicine, Boston Children's Hospital, and Harvard Medical School, Boston, MA, United States. Electronic address: nilesh.mehta@childrens.harvard.edu.
Abstract
BACKGROUND: Malnutrition is prevalent among congenital diaphragmatic hernia (CDH) survivors. We aimed to describe the nutritional status and factors that impact growth over the 12-months following discharge from the pediatric intensive care unit (PICU) in this cohort. METHODS: CDH survivors, who were discharged from the PICU from 2000 to 2010 with follow-up of at least 12months, were included. Nutritional intake, anthropometric, and clinical variables were recorded. Multivariable linear regression was used to determine factors associated with weight-for-age Z-scores (WAZ) at 12months. RESULTS: Data from 110 infants, 67% male, 50% patch repair, were analyzed. Median (IQR) WAZ for the cohort was -1.4 (-2.4 to -0.3) at PICU discharge and -0.4 (-1.3 to 0.2) at 12-months. The percentage of infants with significant malnutrition (WAZ<-2) decreased from 26% to 8.5% (p<0.001). Patch repair (p=0.009), protein intake<2.3g/kg/day (p=0.014), and birth weight (BW)<2.5kg (p<0.001) were associated with lower WAZ at 12-months. CONCLUSIONS: CDH survivors had a significantly improved nutritional status in the 12-months after PICU discharge. Patch repair, lower BW, and inadequate protein intake were significant predictors of lower WAZ at 12-months. A minimum protein intake in the PICU of 2.3g/kg/day was essential to ensure optimal growth in this cohort.
BACKGROUND:Malnutrition is prevalent among congenital diaphragmatic hernia (CDH) survivors. We aimed to describe the nutritional status and factors that impact growth over the 12-months following discharge from the pediatric intensive care unit (PICU) in this cohort. METHODS: CDH survivors, who were discharged from the PICU from 2000 to 2010 with follow-up of at least 12months, were included. Nutritional intake, anthropometric, and clinical variables were recorded. Multivariable linear regression was used to determine factors associated with weight-for-age Z-scores (WAZ) at 12months. RESULTS: Data from 110 infants, 67% male, 50% patch repair, were analyzed. Median (IQR) WAZ for the cohort was -1.4 (-2.4 to -0.3) at PICU discharge and -0.4 (-1.3 to 0.2) at 12-months. The percentage of infants with significant malnutrition (WAZ<-2) decreased from 26% to 8.5% (p<0.001). Patch repair (p=0.009), protein intake<2.3g/kg/day (p=0.014), and birth weight (BW)<2.5kg (p<0.001) were associated with lower WAZ at 12-months. CONCLUSIONS: CDH survivors had a significantly improved nutritional status in the 12-months after PICU discharge. Patch repair, lower BW, and inadequate protein intake were significant predictors of lower WAZ at 12-months. A minimum protein intake in the PICU of 2.3g/kg/day was essential to ensure optimal growth in this cohort.
Authors: Daniel J Raiten; Alison L Steiber; Susan E Carlson; Ian Griffin; Diane Anderson; William W Hay; Sandra Robins; Josef Neu; Michael K Georgieff; Sharon Groh-Wargo; Tanis R Fenton Journal: Am J Clin Nutr Date: 2016-01-20 Impact factor: 7.045
Authors: Augusto Zani; Wendy K Chung; Jan Deprest; Matthew T Harting; Tim Jancelewicz; Shaun M Kunisaki; Neil Patel; Lina Antounians; Pramod S Puligandla; Richard Keijzer Journal: Nat Rev Dis Primers Date: 2022-06-01 Impact factor: 52.329
Authors: Esther van Puffelen; Jessie M Hulst; Ilse Vanhorebeek; Karolijn Dulfer; Greet Van den Berghe; Sascha C A T Verbruggen; Koen F M Joosten Journal: JAMA Netw Open Date: 2018-09-07