RESUMO
Introducción: La malnutrición y la deficiencia de micronutrientes son complicaciones frecuentes en los pacientes con parálisis cerebral (PC). Objetivo: Analizar los niveles de vitamina D (VitD) en pacientes PC en Nutrición Enteral Domiciliaria (NED). Material y Métodos: Estudio retrospectivo analítico de corte transversal. Se incluyeron pacientes PC, e/ 2-18 años, con dosaje de VitD al final del invierno 2021. Se analizó: sexo, edad, discapacidad por Gross Motor Scale (GMS), estado nutricional, drogas antiepilépticas, fórmula, aporte de VitD, volumen, vía de acceso, gasto energético basal (GEB). Se agruparon: Grupo I (GI VitD ≥ 30 ng/ml) GII (VitD ≤ 29 ng/ml). Resultados: se incluyeron 34 pacientes PC, 15 femeninos (44,11 %), edad media 10,87 años (DS 4,78), todos fueron grado V (GMS). La media de Z score de IMC (OMS) fue -1,33 (DS 3,14). Todos recibieron NE diaria. El aporte medio fue de 1270 Kcal (DE:243), 1,16 (Kcal sobre lo estimado según Schofield). Las fórmulas aportaron el 80% del requerimiento de VitD. Los niveles sanguíneos de VitD mostraron: 16 pacientes ≥ de 30 ng/ml y 18 ≤ 29 ng/ml. 14 fueron deficientes y 4 insuficientes. El 59% (20) de los pacientes recibían medicación anticonvulsivante. No se encontraron diferencias significativas entre G1 y G2 para sexo, edad, Z score de IMC, aporte de VitD, calorías recibidas/ GMB y medicación anticonvulsivante. Conclusión: El alto porcentaje de pacientes PC pediátricos con niveles subóptimos de VitD muestra que se trata de una población de riesgo y sugiere la necesidad del chequeo sistemático para una adecuada prevención y tratamiento
Introduction: Malnutrition and micronutrient deficiencies are frequent complications in patients with cerebral palsy (CP). Objective: to analyze the levels of vitamin D (VitD) in CP patients receiving Home Enteral Nutrition (HEN). Material and Methods: Retrospective analytical cross-sectional study. CP patients, from 2 to 18 years old, with measured VitD at the end of winter 2021, were included. The following study variables were analyzed: sex, age, disability by Gross Motor Scale (GMS), nutritional status, antiepileptic drugs, formula, VitD intake, volume, access route, basal energy expenditure (BEE), according to Schofield P/T. They were grouped: Group I (GI VitD ≥ 30 ng/ml) GII (VitD ≤ 29 ng/ml). Results: 34 CP patients were included, 15 female (44.11 %), mean age 10.87 years (SD 4.78), all grade V (GMS). The mean BMI Z score (WHO) was -1.33 (SD 3.14). EN was daily in all, 33 due to gastrostomy and 1 due to SNG. The average contribution 1270 Kcal (DS243), 1.16 (Kcal received according to Schofield). The formulas provided 80 % of the VitD requirement. VitD blood levels showed: 16 patients (47 %) ≥ 30 ng/ml and 18 (52 %) ≤ 29 ng/ml. 14 (41.17 %) were deficient and 4 insufficient (11.76 %). 59 % (20) of the patients received anticonvulsant medication. No significant differences were found between G1 and G2 for sex, age, BMI Z score, VitD intake, calories received/GMB and anticonvulsant medication. Conclusion: The high percentage of pediatric CP patients with suboptimal levels of Vit D shows that it is a population at risk and suggests the need for systematic check-up for adequate prevention and treatment
Assuntos
Humanos , Criança , Adolescente , Adulto , Paralisia Cerebral , Nutrição EnteralRESUMO
Introducción: los niños con parálisis cerebral (PC) presentan habitualmente compromiso nutricional. Objetivos: evaluar el estado nutricional antropométrico de niños con PC con nutrición enteral (NE) asistidos por un equipo especializado en domicilio. Materiales y métodos: cohorte retrospectiva sobre datos de historia clínica, evaluados durante un año (2018-2019). Se evaluó: z score de .peso (Pz), z score de talla (Tz), z score de índice de masa corporal (IMC) (IMCz). En los que no pudo usarse pediómetro, se utilizó medición de la longitud de la tibia (LT). Se los dividió en:
Introduction: children with cerebral palsy (CP) usually present nutritional compromise. Objectives: to evaluate the anthropometric nutritional status of children with CP with enteral nutrition (EN) assisted by a specialized team at home. Materials and methods: a retrospective cohort study on clinical report data, evaluated during one year (2018-2019). The following were evaluated: weight z score (Pz), height z score (Tz), BMI z score (BMIz). In those that could not be used a pediometer, measurement of the tibia length (TL) was used. They were divided into: <10 years (Group1) and >10 years (Group2). The following were excluded: genetic syndromes and/or refractory epilepsy, and those who did not adhere to nutritional treatment. Complications associated with nutritional treatment were recorded. Results: 72 patients were analyzed, Group 1: 38 patients: baseline: Tz x -2.85 (-4.50, -1.41), Pz x -2.83 (-3.72, -1.59), BMIz 0,93 (SD 2,21). Final, Tz was x -2.55 (-3.92, -1.42), Pz x -2.15 (-3.05, -1.03), BMI x: 15.95. Significant differences were observed between the start-end in P p<0.001, T p0.001, and Pz p0.030. Group 2: 34 patients, 2018: Tz x -3.00 (-3.81, -1.53), Pz x -2.63 (-3.68, -2.23), BMIz x -1,75 (DE:1,73). Final Tz x -2.84 (-4.13, -1.25), Pz x -2.84 (-3.42,-1.83) BMI -1,53 (DE: 2,19).Significant differences were observed between the beginning and end of the period observed in the Pz (p=0.049). No severe complications were recorded (hospitalizations, bronchial aspiration, death). Conclusions: an improvement in nutritional status and no severe complications were observed in the period studied