Clinical Practice Guidelines for the Pediatric Inpatient Treatment of Severe Acute Malnutrition 2019
Keywords:
severe acute malnutrition, inpatient, pediatric patient, clinical practice guideline, nutritional managementAbstract
Child malnutrition is a major global health problem, including here inThailand. It can affect a child's growth as well as cognitive development. Children with severe acute malnutrition (SAM) are at increased risk of morbidity and mortality. Therefore, understanding the pathophysiology, recognition of the disease and timely management will improve clinical outcomes and reduce complications and death.
The current clinical practice guidelines were developed by the Pediatric Nutrition Association of Thailand and endorsed by the Royal College of Pediatricians of Thailand, with the intention to improve the quality of inpatient care of acute severely malnourished pediatric patients in the setting of secondary care hospitals and higher. The guidelines consist of criteria for admission, diagnosis, management of SAM, prevention and treatment of refeeding syndrome, criteria for discharge, and prevention of SAM. However, the use of the guidelines should be tailored to match the context of individual hospital and individual patient which may be different.
References
World Health Organization. Management of severe malnutrition: a manual for physicians and other senior health workers. Geneva: World Health Organization;1999.
World Health Organization. Guideline: Updates on the management of severe acute malnutrition in infants and children. Geneva: World Health Organization;2013.
สำนักงานพัฒนานโยบายสุขภาพระหว่างประเทศ. รายงานภาระโรคและการบาดเจ็บของประชากรไทย พ.ศ. 2557. นนทบุรี:บริษัท เดอะ กราฟิโก ซิสเต็มส์ จำกัด;2560.
National Statistical Office, UNICEF, Ministry of Public Health, National Health Security Office, Thai Health Promotion Foundation, International Health Policy Program. Thailand Multiple Indicator Cluster Survey 2012;2014.
ลัดดา เหมาะสุวรรณ. ภาวะขาดพลังงานและโปรตีน. ใน: ประยงค์ เวชวนิชสนอง, วนพร อนันตเสรี, บรรณาธิการ. กุมารเวชศาสตร์ เล่ม 1. กรุงเทพฯ: สหมิตรพัฒนาการพิมพ์;2559. หน้า 275–88.
Oshikoya KA, Senbanjo IO. Pathophysiological changes that affect drug disposition in protein-energy malnourished children. Nutr Metab 2009;6:50.
Manary MJ, Hart CA, Whyte MP. Severe hypophosphatemia in children with kwashiorkor is associated with increased mortality. J Pediatr 1998;133:789-91.
Waterlow JC, Golden MH. Serum inorganic phosphate in protein-energy malnutrition. Eur J Clin Nutr 1994;48:503-6.
Rytter MJH, Kolte L, Briend A, Friis H, Christensen VB. The immune system in children with malnutrition-A systematic review. PLoS ONE 2014;9:e105017.
Grantham-McGregor S, Cheung YB, Cueto S, Glewwe P, Richter L, Strupp B, et al. Developmental potential in the first 5 years for children in developing countries. Lancet 2007;369:60-70.
Williams P, Berkley J. Severe acute malnutrition update: current WHO guidelines and the WHO essential medicine list for children. [Internet]. 2016. [cited 2017 Feb 4]. Available from: http://www.who.int/selection_medicines/committees/expert/21/applications/s6_paed
_antibiotics_appendix7_sam.pdf.
Sperling M. Hypoglycemia. In: Kliegman R, Stanton B, St Geme III J, Schor N, editors. Nelson Textbook of Pediatrics. 20th ed. Philadelphia: Elsevier Saunders; 2016:773–88.
Thornton P, Stanley C, Leon D, Harris D, Haymond M, Hussain K, et al. Recommendations from the Pediatric Endocrine Society for Evaluation and Management of Persistent Hypoglycemia in Neonates, Infants, and Children. J Pediatr 2015;167:238–45.
Tickell K, Denno D. Inpatient management of children with severe acute malnutrition: a review of WHO guidelines. Bull World Health Organ 2016;94:642-51.
National Institute of Health and Care Excellence. Diarrhoea and vomiting caused by gastroenteritis in under 5s: diagnosis and management. [internet] 2009. [cited 2017 Dec 30]. Available from: https://www.nice.org.uk/guidance/cg84/chapter/1-guidance#fluid-management.
Asmar A, Mohandas R, Wingo C. A physiologic-based approach to the treatment of a patient with hypokalemia. Am J Kidney Dis 2012;60:492-7.
Daly K, Farrington E. Hypokalemia and hyperkalemia in infants and children: pathophysiology and treatment. J Pediatr Health Care 2013;27:486-96.
Zieg J, Gonsorcikova L, Landau D. Current views on the diagnosis and management of hypokalaemia in children. Acta Paediatr 2016;105:762-72.
Fuentebella J, Kerner JA. Refeeding syndrome. Pediatr Clin N Am 2009;56:1201-10.
Boateng A, Sriram K, Meguid M, Crook M. Refeeding syndrome: Treatment considerations based on collective analysis of literature case reports. Nutrition 2010;26:156-67.
Brown K, Dickerson R, Morgan L, Alexander K, Minard G, RO. B. A new graduated dosing regimen for phosphorus replacement in patients receiving nutrition support. JPEN J Parenter Enteral Nutr 2006;30:209-14.
Imel E, Carpenter TO. A practical clinical approach to paediatric phosphate disorders. In: Allgrove J, Shaw NJ, editors. Calcium and bone disorders in children and adolescents. Endocr Dev. 2nd ed. Basel: Karger; 2015:134-61.
Zazzo J-F, Troché G, Ruel P, Maintenant J. High incidence of hypophosphatemia in surgical intensive care patients: Efficacy of phosphorus therapy on myocardial function. Intensive Care Med 1995;21:826-31.
Mehanna H, Moledina J, Travis J. Refeeding syndrome: what it is, and how to prevent and treat it. BMJ 2008;336:1495-8.
Weisinger J, Bellorín-Font E. Magnesium and phosphorus. Lancet 1998;352:391-6.
Alcoba G, Kerac M, Breysse S, Salpeteur C, Galetto-Lacour A, Briend A, et al. Do children with uncomplicated severe acute malnutrition need antibiotics? A systematic review and meta-analysis. PloS One 2013;8:e53184.
Lazzerin iM, Tickell D. Antibiotics in severely malnourished children: systematic review of efficacy, safety and pharmacokinetics. Bull World Health Organ 2011;89:593-606.
Million M, Lagier J-C, Raoult D. Meta-analysis on efficacy of amoxicillin in uncomplicated severe acute malnutrition. Microb Pathog 2017;106 (supplement C):76-7.
Trehan I, Goldbach H, LaGrone L, Meuli G, Wang R, Maleta K, et al. Antibiotics as part of the management of severe acute malnutrition. Malawi Med J 2016;28:123–30.
Ross D. Recommendations for vitamin A supplementation. J Nutr 2002;132:2902S- 29026S.
Brown KH, Rivera JA, Bhutta Z, Gibson RS, King JC, et al. International Zinc Nutrition Consultative Group (IZiNCG) technical document #1. Assessment of the risk of zinc deficiency in populations and options for its control. Food Nutr Bull. 2004;25(1 Suppl 2):S99-203.
Field CR, Schoeller DA, Brown KH. Body composition of children recovering from severe protein energy malnutrition at two rates of catch-up growth. Am J Clin Nutr 1989;50:1226-75.
Crook MA. Refeeding syndrome: Problems with definition and management. Nutrition 2014;30:1448-55.
Kraft M, Btaiche I, Sacks G. Review of the refeeding syndrome. Nutr Clin Pract 2005;20:625-33.
National Institute for Health and Clinical Excellence. Nutrition support in adults : oral nutrition support, enteral tube feeding and parenteral nutrition. Clinical guideline CG32. [internet] 2006. [cited 2017 Feb 15]. Available from: www.nice.org.uk/page.aspx?o=cg032.
อุมาพร สุทัศน์วรวุฒิ, สุภาพรรณ ตันตราชีวธร, สมโชค คุณสนอง. คู่มืออาหารตามวัยสำหรับทารกและเด็กเล็ก. กรุงเทพฯ: บริษัท บียอนด์เอ็นเทอร์ไพรซ์ จำกัด;2552.
ประไพศรี ศิริจักรวาล, อุมาพร สุทัศน์วรวุฒิ. ข้อแนะนำการบริโภคอาหารเพื่อสุขภาพที่ดี: การทบทวนและวิเคราะห์. กรุงเทพฯ: โรงพิมพ์ องค์การสงเคราะห์ทหารผ่านศึก ในพระบรมราชูปถัมภ์;2555.
Bandsma R, Mendel M, Spoelstra M, Reijngoud D, Boer T, Stellaard F, et al. Mechanisms behind decreased endogenous glucose production in malnourished children. Pediatr Res 2010;68:423-8.
Fjeld C, Schoeller D, Brown KH. Body composition of children recovering from severe protein-energy malnutrition at two rates of catch-up growth. Am J Clin Nutr 1989;50:1266-75.
Downloads
Published
How to Cite
Issue
Section
License
The content and information in the articles published in Thai JPEN วารสารโภชนบำบัด, are the opinions and responsibility of the authors directly. The editorial team is not obliged to agree or take any responsibility.
All articles, content, figures, etc. that have been published in Thai JPEN วารสารโภชนบำบัด are the copyright of Thai JPEN วารสารโภชนบำบัด. If any person or organization require distribution of all or any part of them, please send the request for the written permission from Thai JPEN วารสารโภชนบำบัด only.