Evolução do estado nutricional e da terapia nutricional em pacientes pediátricos acompanhados por equipe multidisciplinar do HSP/EPM
Data
2015-09-30
Tipo
Dissertação de mestrado
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Objetivo: Avaliar o acompanhamento e a terapia nutricional utilizada durante o período de internação hospitalar. Casuística e métodos: Estudo de coorte retrospectivo, com 207 crianças e adolescentes, acompanhados pela equipe multidisciplinar de terapia nutricional. Foram analisados dados coletados do protocolo de atendimento de interconsulta. As variáveis estudadas foram: peso, estatura, circunferência do braço e da panturrilha, tipo de dieta, oferta calórica e protéica, via de administração da dieta, diagnóstico clínico, dias internação e dias de acompanhamento. Para a análise estatística, utilizou: teste de Wilcoxon, teste exato de ficher e Mc Nemar. Resultados: A mediana de idade foi de um ano, predominando como diagnóstico clínico às malformações e os eventos do TGI (22,7%). Constatou-se uma alta prevalência de desnutrição e comprometimento estatural, no entanto ao final do período de internação, observou-se que houve melhora significativa do estado nutricional. Durante toda internação, a via de administração mais freqüente foi a via oral, e as dietas industrializadas foram as mais utilizadas. Ao avaliar a oferta energética e protéica, observou-se que os pacientes tiveram aumento da ingestão comparando-se os dois momentos (p< 0,05). Conclusão: Fundamental o diagnóstico de comprometimentos nutricionais o mais precoce possível, possibilitando traçar a terapia nutricional individualizada, proporcionando a recuperação e/ou manutenção do estado nutricional do paciente e melhorando a sua qualidade de vida.
Objective: To evaluate the monitoring and nutritional therapy used during the hospital stay. Methods: This retrospective cohort study enrolled 207 children and adolescents, and was followed by a multidisciplinary team of nutrition support. We analyzed data collected from inpatient protocols considering two moments: the beginning and end of follow-up. Data collected: length of hospital stay, days of follow-up, clinical diagnosis, anthropometric variables, type of diet, caloric and protein intake and route of administration of the diet. Statistical study: Wilcoxon test, Fisher's exact test and Mc Nemar test. Results: Patients mean age was one years old, having the malformations and the events of the TGI (22.7%) as a predominating clinical diagnosis. A high prevalence of malnutrition and impaired height were found; however, at the end of the hospitalization¿s period, there was a significant improvement of nutritional status. During hospitalization, the most frequent route of administration was oral, and industrialized diets were the most used. When evaluating the energy and protein intake, it was observed that patients had increased their intake by comparing the two moments (p<0.05). Conclusion: These data underscore the importance detecting nutritional impairment as early as possible; enable planning the nutritional support according to the patient's nutritional status, type of disease and clinical severity. So, the deleterious effects of the disease could be attenuated, providing an impact in decreasing morbidity and mortality.
Objective: To evaluate the monitoring and nutritional therapy used during the hospital stay. Methods: This retrospective cohort study enrolled 207 children and adolescents, and was followed by a multidisciplinary team of nutrition support. We analyzed data collected from inpatient protocols considering two moments: the beginning and end of follow-up. Data collected: length of hospital stay, days of follow-up, clinical diagnosis, anthropometric variables, type of diet, caloric and protein intake and route of administration of the diet. Statistical study: Wilcoxon test, Fisher's exact test and Mc Nemar test. Results: Patients mean age was one years old, having the malformations and the events of the TGI (22.7%) as a predominating clinical diagnosis. A high prevalence of malnutrition and impaired height were found; however, at the end of the hospitalization¿s period, there was a significant improvement of nutritional status. During hospitalization, the most frequent route of administration was oral, and industrialized diets were the most used. When evaluating the energy and protein intake, it was observed that patients had increased their intake by comparing the two moments (p<0.05). Conclusion: These data underscore the importance detecting nutritional impairment as early as possible; enable planning the nutritional support according to the patient's nutritional status, type of disease and clinical severity. So, the deleterious effects of the disease could be attenuated, providing an impact in decreasing morbidity and mortality.
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Citação
SOUZA, Belisa Junqueira de. Evolução do estado nutricional e da terapia nutricional em pacientes pediátricos acompanhados por equipe multidisciplinar do HSP/EPM. 2015. 67 f. Dissertação (Mestrado em Nutrição) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, 2015.