RESUMO
Background & aims: Home enteral nutrition is used increasingly in pediatric populations. Our objective was to describe the profile of pediatric patients requiring this treatment. Material and methods: All patients under 18 years old requiring treatment with home enteral nutrition between January 1995 and December 2004 were analyzed retrospectively. Results: 304 patients were studied (157 boys). The mean age at the start of treatment was 4.02 ± 4.09 years, median of 2.5 years; 28% of all patients were under 1 year. The main indications were oncological disease in 91 patients (29.9%) and digestive diseases in 84 (27.6%). There were significant differences depending on the clinical diagnosis for the start age, type of access, infusion regime and formula prescribed. Nutrients were delivered by nasogastric tube in 218 patients (71.7%). Overnight enteral nutrition was the preferred infusion regime in 155 patients (51%). Adult or pediatric polymeric formulas were mostly prescribed in 190 patients (62.5%). The mean treatment duration was 306 ± 544 days. Conclusion: In our series, enteral support usually begins at an early age. Its characteristics varied depending on patient pathology. Knowledge of the pediatric patient profile is important to design the most effective strategy for home enteral nutrition (AU)
Introducción y objetivos: La nutrición enteral domiciliaria es un soporte nutricional cada vez más utilizado en población pediátrica. Nuestro objetivo ha sido describir el perfil de un grupo de pacientes pediátricos que precisaron este tratamiento. Material y métodos: Se analizaron retrospectivamente todos los pacientes menores de 18 años que precisaron tratamiento con nutrición enteral domiciliaria entre enero 1995 y diciembre 2004. Resultados: Se estudiaron 304 pacientes (157 niños). La edad media al inicio del tratamiento fue de 4,02 ± 4,09 años, con una mediana de 2,5 años; un 28% de los pacientes eran menores de 1 año. Las indicaciones principales fueron la enfermedad oncológica en 91 pacientes (29,9%) y la digestiva en 84 (27,6%). Se encontraron diferencias significativas en función del diagnóstico clínico para la edad de inicio, el tipo de acceso, el modo de administración y la fórmula prescrita. El tipo de acceso más utilizado fue la sonda nasogástrica en 218 pacientes (71,7%). El régimen de infusión más utilizado fue la nutrición enteral nocturna en 155 pacientes (51%). Se prescribió principalmente fórmula polimérica de adultos o pediátrica en 190 pacientes (62,5%). La duración media del tratamiento fue de 306 ± 544 días. Conclusión: En nuestra serie, el soporte enteral suele iniciarse a edades muy tempranas. Sus características variaron en función de la patología del paciente. Conocer el perfil del paciente pediátrico es importante para diseñar la estrategia más eficaz en el uso de la nutrición enteral domiciliaria (AU)
Assuntos
Humanos , Masculino , Feminino , Criança , Nutrição Enteral/métodos , Moradias Assistidas/tendências , Nutrição da Criança , Apoio Nutricional/métodos , Gastrostomia , JejunostomiaRESUMO
BACKGROUND & AIMS: Home enteral nutrition is used increasingly in pediatric populations. Our objective was to describe the profile of pediatric patients requiring this treatment. MATERIAL AND METHODS: All patients under 18 years old requiring treatment with home enteral nutrition between January 1995 and December 2004 were analyzed retrospectively. RESULTS: 304 patients were studied (157 boys). The mean age at the start of treatment was 4.02 ± 4.09 years, median of 2.5 years; 28% of all patients were under 1 year. The main indications were oncological disease in 91 patients (29.9%) and digestive diseases in 84 (27.6%). There were significant differences depending on the clinical diagnosis for the start age, type of access, infusion regime and formula prescribed. Nutrients were delivered by nasogastric tube in 218 patients (71.7%). Overnight enteral nutrition was the preferred infusion regime in 155 patients (51%). Adult or pediatric polymeric formulas were mostly prescribed in 190 patients (62.5%). The mean treatment duration was 306 ± 544 days. CONCLUSION: In our series, enteral support usually begins at an early age. Its characteristics varied depending on patient pathology. Knowledge of the pediatric patient profile is important to design the most effective strategy for home enteral nutrition.
Assuntos
Nutrição Enteral/estatística & dados numéricos , Adolescente , Criança , Pré-Escolar , Doenças do Sistema Digestório/terapia , Nutrição Enteral/métodos , Insuficiência de Crescimento/terapia , Feminino , Alimentos Formulados , Serviços de Assistência Domiciliar , Humanos , Masculino , Neoplasias/terapia , Doenças do Sistema Nervoso/terapia , Estudos RetrospectivosRESUMO
Las anomalías en la disposición espacial de las vísceras toracoabdominales son entidades de muy baja prevalencia. Los síndromes heterotáxicos o situs ambiguos se asocian muy frecuentemente con cardiopatías congénitas graves, mientras que en el caso del situs inversus totalis (imagen especular con respecto a la normalidad) éstas se observan en el 3-5% de los pacientes, unas 6 veces más que en la población general. Se expone el caso de una niña de 26 meses de edad, portadora de dos defectos septales interventriculares en presencia de situs inversus totalis, y se incide en la importancia de realizar un estudio cardiológico ante anomalías de situs, así como en la necesidad de tener en cuenta la posibilidad de asociación de discinesia ciliar primaria con el trastorno visceral que presentamos (AU)
The prevalence of anomalies in the position of thoracoabdominal organs is very low. Heterotaxy syndromes or situs ambiguous are very often associated with severe congenital heart disease, whereas, in the case of situs inversus totalis (a mirror image of the normal anatomy), heart defects are observed in 3% to 5%of the patients, approximately 6 times more frequently than in the general population. We report the case of a 26-month-old girl with visceral situs inversus totalis, in addition to two ventricular septal defects. We also stress the importance of carrying out cardiac screening in all patients with situs anomalies, as well as the need to consider the possible association between primaryciliary dyskinesia and situs inversus totalis (AU)
