Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2008 Jun;63(3):357-62.
doi: 10.1590/s1807-59322008000300012.

Hospital malnutrition and inflammatory response in critically ill children and adolescents admitted to a tertiary intensive care unit

Artur F Delgado  1 , Thelma S Okay, Claudio Leone, Buford Nichols, Gilda Maria Del Negro, Flávio Adolfo Costa Vaz
Affiliations

Hospital malnutrition and inflammatory response in critically ill children and adolescents admitted to a tertiary intensive care unit

Artur F Delgado et al. Clinics (Sao Paulo). 2008 Jun.

Abstract

Critical illness has a major impact on the nutritional status of both children and adults. A retrospective study was conducted to evaluate the incidence of hospital malnutrition at a pediatric tertiary intensive care unit (PICU). Serum concentrations of IL-6 in subgroups of well-nourished and malnourished patients were also evaluated in an attempt to identify those with a potential nutritional risk.

Methods: A total of 1077 patients were enrolled. Nutritional status was evaluated by Z-score (weight for age). We compared mortality, sepsis incidence, and length of hospital stay for nourished and malnourished patients. We had a subgroup of 15 patients with severe malnutrition (MN) and another with 14 well-nourished patients (WN). Cytokine IL-6 determinations were performed by enzyme-linked immunosorbent assay.

Results: 53% of patients were classified with moderate or severe malnutrition. Similar amounts of C- reactive protein (CRP) were observed in WN and MN patients. Both groups were able to increase IL-6 concentrations in response to inflammatory systemic response and the levels followed a similar evolution during the study. However, the mean values of serum IL-6 were significantly different between WN and MN patients across time, throughout the study (p = 0.043).

Discussion: a considerable proportion of malnourished patients need specialized nutritional therapy during an intensive care unit (ICU) stay. Malnutrition in children remains largely unrecognized by healthcare workers on admission.

Conclusions: The incidence of malnutrition was very high. Malnourished patients maintain the capacity to release inflammatory markers such as CRP and IL-6, which can be considered favorable for combating infections On the other hand, this capacity might also have a significant impact on nutritional status during hospitalization.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Therapeutic Intervention Scoring System (TISS) evolution in Mn and Wn patients during the period of study
Figure 2
Figure 2
IL-6 serum concentrations in malnourished and well-nourished patients during the period of the study
See this image and copyright information in PMC

References

    1. Sauerwein RW, Mulder JA, Mulder L, Lowe B, Peshu N, Demacker PNM, et al. Inflammatory mediators in children with protein-energy malnutrition. Am J Clin Nutr. 1997;65:1534–9. - PubMed
    1. Coss-Bu JA, Klish WJ, Walding D, Stein F, Smith EO, Jefferson LS. Energy metabolism, nitrogen balance, and substrate utilization in critically ill children. Am J Clin Nutr. 2001;74:664–9. - PubMed
    1. Messer J, Eyer D, Donato L, Gallati, Matis J, Simeoni U. Evaluation of interleukin-6 and soluble receptors of tumor necrosis factor for early diagnosis of neonatal infection. J Pediatr. 1996;129:574–80. - PubMed
    1. Lyoumi S, Tamion F, Petit J, Déchelotte P, Dauguet C, Scotté M, et al. Induction and modulation of acute-phase response by protein malnutrition in rats: Comparative effect of systemic and localized inflammation on interleukin-6 and acute-phase protein synthesis. J Nutr. 1998;128:166–74. - PubMed
    1. Delgado AF, Kimura HM, Cardoso AL, Uehara D, Carrazza FR. Nutritional follow-up of critically ill infants receiving short term parenteral nutrition. Rev Hosp Clin Fac Med S Paulo. 2000;55:3–8. - PubMed