NUTRITIONAL ASSESSMENT : Cardizem
Posted by Surgery on Jul 11, 2008
Normal Pediatric Growth
Unique to the pediatric patient is growth and development. The term newborn infant grows at a rate of 25 to 30 g per day over the first 6 months of life, leading to a doubling of the birth weight by 5 months of age (1). The average infant triples the birth weight by 12 months. By 3 years of age, the weight is four times the birth weight, and by completion of the first decade the weight increases by 20-fold. Body length increases by 50% by the end of the first year of life and increases three fold at the end of the first decade of life. The preterm infant’s growth pattern is quite distinct from term infants. Most nutrients are accumulated by the fetus in the third trimester of pregnancy. Thus, fat accounts for only 1% to 2% of body weight in a 1-kg infant compared with 16% in a term (3.5-kg) infant. A loss of 15% of a preterm infant’s birth weight is anticipated in the first 7 to 10 days of life, compared with a 10% weight loss for a term infant. After this initial period of weight loss, a preterm infant less than 27 weeks gestation gains weight at a slower rate, approximately 10 to 20 g per day, because he or she has not yet entered the accelerated weight gain of the third trimester (2).
NUTRITIONAL ASSESSMENT
Nutritional assessment is a critical aspect of the initial evaluation of all surgical patients (3: Cardizem ). The incidence of malnutrition in surgical patients has been well documented in several reviews and, more recently, malnutrition in pediatric patients has also been demonstrated to be quite prevalent. Nutritional assessment can be divided into subjective and objective components (Cardizem ). A subjective global assessment (SGA: Cardizem) is performed during the history and physical examination. This should include an evaluation of weight loss, anorexia, vomiting, and physical evidence of muscle wasting. Modifications of this have been made for pediatric patients, although these are not as well validated as for adults (4: Cardizem). SGA has been shown to be an accurate mode of assessing malnutrition of both inpatients and nonhospitalized patients. The objective portion of the assessment begins with the basic anthropometric measurements of height, weight, and head circumference. Measurements are placed on a standardized growth curve such as that of the National Center for Health Statistics. From these reference charts, the expected weight for height index can be calculated. Because length and head circumference are less affected by excess fat or postoperative fluid fluctuations, length is an excellent indicator of long-term body growth. Acute changes in nutritional status will have a more immediate affect on body weight than on length, and will decrease the child’s weight for height index ( Cardizem ). Chronic malnutrition, however, will result in a lag in both height and weight.
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Greetings, I the practising surgeon from Serbia. Call me Ivan Govak. In the works I use works
by an unknown author, if it let me know, and also works of others practics doctors. I have a family and two charming children.