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Malnutrition bei pädiatrischen Patienten

Erkennung und Beurteilung

Malnutrition in pediatric patients

Recognition and assessment

  • Leitthema
  • Published:
Monatsschrift Kinderheilkunde Aims and scope Submit manuscript

Zusammenfassung

Hintergrund

Mangelernährung bei Kindern im Krankenhaus ist immer noch sehr weit verbreitet, v. a. bei Kindern mit einer Grunderkrankung.

Ziel der Arbeit

Weltweite Prävalenzraten und die Folgen der Mangelernährung bei Kindern und Jugendlichen werden beschrieben.

Material und Methoden

Für die Einstufung der akuten und der chronischen Unterernährung werden „Gewicht für Länge“ (weight-for-height) und „Größe für das Alter“ (height-for-age) verwendet, z. B. als „standard deviation scores“. Auch der Body-Mass-Index (BMI) kann für die Bewertung akuter Mangelernährung eingesetzt werden.

Ergebnisse

Im Krankenhaus ist die Identifizierung von Kindern, die unterernährt sind oder ein Risiko für eine Mangelernährung aufweisen, sehr wichtig, v. a. hinsichtlich der Auswirkungen der Ernährung auf die Behandlung und die Verfügbarkeit von Ressourcen. Aufgrund der Vielfalt von Erkrankungen und Syndromen bei hospitalisierten Kindern sind die Beurteilung des Ernährungszustands und die richtige Interpretation der anthropometrischen Daten essenziell.

Schlussfolgerung

Vorgeschlagene pädiatrische Screening-Tools zur Identifikation von Kindern mit dem hohen Risiko einer Mangelernährung sind nicht ausreichend validiert und können bisher nicht für die breite klinische Anwendung empfohlen werden.

Abstract

Background

Malnutrition in hospitalized children is still very prevalent, especially in children with an underlying disease.

Aim

The purpose of this review is to describe the worldwide prevalence and the consequences of malnutrition in children and adolescents.

Material and methods

The weight-for-height and height-for-age standard deviation scores are used for classification for acute and chronic malnutrition. The body mass index-for-age can also be used for the definition of acute malnutrition.

Results

In a hospital-based setting, identification of children who are malnourished or at risk for malnutrition is important given the impact of nutrition on the outcome and the availability of resources for interventions. Because of the diversity of medical conditions and syndromes in hospitalized children the assessment of nutritional status and interpretation of anthropometric data need a tailored approach.

Conclusion

The proposed pediatric screening tools for identification of children with an increased risk of developing malnutrition have not been adequately validated and cannot be recommended for routine clinical use at this time.

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Abbreviations

BMI:

Body-Mass-Index

HFA:

„height-for-age“

LoS:

„length of stay“

MUAC:

„mid-upper arm circumference“

NRS:

Nutrition Risk Score

PNRS:

Pediatric Nutritional Risk Score

PYMS:

Paediatric Yorkhill Malnutrition Score

SDS:

„standard deviation score“

SGNA:

Subjective Global Nutritional Assessment

STAMP:

Screening Tool for the Assessment of Malnutrition in Paediatrics

STRONGkids:

Screening Tool for Risk of Impaired Nutritional Status and Growth

WFA:

„weight-for-age“

WFH:

„weight-for-height“

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Danksagung

Der Autor dankt Frau Manja Fleddermann für ihre Hilfe bei Sprachkorrekturen des Manuskripts.

Einhaltung ethischer Richtlinien

Interessenkonflikt . M. Chourdakis gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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  1. Medizinische Schule, Universitätskampus, Aristoteles Universität Thessaloniki, 54124, Thessaloniki, Griechenland

    M. Chourdakis

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Correspondence to M. Chourdakis.

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Chourdakis, M. Malnutrition bei pädiatrischen Patienten. Monatsschr Kinderheilkd 164, 12–18 (2016). https://doi.org/10.1007/s00112-015-3430-8

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