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Vol. 51. Núm. 4.
Páginas 183-196 (abril 2004)
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Vol. 51. Núm. 4.
Páginas 183-196 (abril 2004)
Acceso a texto completo
Nutrición enteral y parenteral en pediatría
Enteral and parenteral nutrition in pediatrics
Visitas
70428
J.M. Moreno
Autor para correspondencia
jmoreno.hdoc@salud.madrid.org

Correspondencia: Dr. J.M. Moreno Villares. Departamento de Pediatría. Hospital 12 de Octubre. Ctra. de Andalucía, km 5,400. 28041 Madrid. España.
Unidad de Nutrición Clínica. Hospital 12 de Octubre. Madrid. España
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Bibliografía
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Estudios en niños hospitalizados muestran que existe una incidencia significativa de desnutrición, tanto aguda como crónica. Proporcionar un adecuado soporte nutricional es parte importante de los cuidados de cualquier niño hospitalizado, esté o no desnutrido. Para conseguir cubrir las necesidades energéticas y proteínicas de todo el arco de edades pediátricas, además de las fórmulas infantiles para lactantes sanos y de fórmulas infantiles especiales, disponemos de fórmulas enterales y de sistemas de alimentación intravenosa.

La nutrición enteral es el método de elección en los niños que requieren soporte nutricional y que tienen un tracto gastrointestinal funcionante, y se reserva la nutrición parenteral para las situaciones en las que la función gastrointestinal está afectada de forma importante.

Como el recién nacido, el lactante y el niño tienen unas necesidades especiales, las técnicas de soporte nutricional difieren en gran medida de las utilizadas en el paciente adulto. Así, se han desarrollado productos específicos para niños al tiempo que protocolos de actuación. En este artículo se resumen algunas de las características más relevantes de la nutrición artificial en el niño.

Palabras clave:
Soporte nutricional
Nutrición enteral
Nutrición parenteral
Niños

Studies in hospitalized children report a significant incidence of both acute and chronic malnutrition. The provision of adequate nutritional intake is an important part of the care of all hospitalized children whether previously malnourished or not.

To meet the nutritional needs of the entire age range of pediatric patients, in addition to infant formulas and specialized infant formulas, enteral and intravenous feeding are also required.

Enteral nutrition is the preferred method of nutritional support in children with a functioning gastrointestinal tract, while parenteral nutrition is reserved for children with severely compromised gut function.

Because of the special needs and characteristics of neonates, infants and children, the use of artificial nutrition in pediatrics differs greatly from that in adults. Specific products and protocols have been developed for children. The present article summarizes the most important features of artificial nutritional support in this age range.

Key words:
Nutrition support
Enteral nutrition
Parenteral nutrition
Children
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Bibliografía
[1.]
ASPEN Board of Directors and the Clinical Gidelines Task Force.
Guidelines for the use of parenteral and enteral nutrition in adult and pediatric patients Section I. Introduction.
JPEN, 26 (2002), pp. 1SA-6SA
[2.]
ASPEN Board of Directors and the Clinical Gidelines Task Force.
Guidelines for the use of parenteral and enteral nutrition in adult and pediatric patients Section V. Administration of specialized nutrition support.
JPEN, 26 (2002), pp. 18SA-20SA
[3.]
G. Hernández, N. Velasco, C. Wainstein, L. Castillo, G. Bugedo, A. Maiz, et al.
Gut mucosal atrophy after a short enteral fasting period in critically ill patients.
J Crit Care, 14 (1999), pp. 73-77
[4.]
A.A. Ziegler, P.J. Thureen, S.J. Carlson.
Aggressive nutrition of the very low birthweight infant.
Clin Perinatol, 29 (2002), pp. 225-244
[5.]
C.L. Berseth.
Minimal enteral nutrition in infants and children.
Nutrition in the infant. Problems and practical procedures, pp. 57-68
[6.]
American Gastroenterological Association Technical Review on tube feeding for enteral nutrition.
Gastroenterology, 108 (1995),
[7.]
M.W.L. Gauderer, J.L. Ponsky, R.J. Izant.
Gastrostomy without laparotomy: a percutaneous endoscopic technique.
J Pediatr Surg, 15 (1980), pp. 872-875
[8.]
P. Davidson.
Percutaneous endoscopic gastrostomy.
Nutrition in the infant. Problems and practical procedures, pp. 103-110
[9.]
S. Gopalan, S. Khanna.
Enteral nutrition delivery technique.
Curr Opin Clin Nutr Metab Care, 6 (2003), pp. 313-317
[10.]
E. Panadero, J. López Herce, L. Caro, A. Sánchez, E. Cuetro, A. Bustinza, et al.
Transpyloric enteral feeding in critically ill patients.
J Pediatr Gastroenterol Nutr, 26 (1998), pp. 43-48
[11.]
H.C. Lin, G.W. VanCritters.
Stopping enteral feeding for arbitrary gastric residual volumes may not be physiologically sound: results of a computer simulated model.
J Parent Ent Nutr, 21 (1997), pp. 280-289
[12.]
L.M. Murphy, V. Bickford.
Gastric residuals in tube feeding: how much is too much.
Nutr Clin Pract, 14 (1999), pp. 304-306
[13.]
T. Johnson.
Enteral feeding.
Clinical paediatrics dietetics 2nd ed, pp. 31-41
[14.]
G. Tamayo López, M.R. Sáenz de Urturi, C. Hernández-Saez, C. Pedrón Giner, M.D. García Novo.
Fórmulas infantiles especiales.
An Esp Pediatr, 47 (1997), pp. 455-465
[15.]
ASPEN Board of Directors and the Clinical Gidelines Task Force.
Guidelines for the use of parenteral and enteral nutrition in adult and pediatric patients. Section XII. Administration of specialized nutrition support. Issues unique to pediatrics.
JPEN, 26 (2002), pp. 97SA-100SA
[16.]
J.M. Moreno Villares, M.J. Galiano Segovia, M. Marín Ferrer.
Alteraciones de la conducta alimentaria en pacientes que precisaron nutrición enteral durante el primer año de vida.
Nutr Hosp, 13 (1998), pp. 90-94
[17.]
J. Pinelli, A. Symington.
Non-nutritive sucking for promoting physiologic stability and nutrition in preterm infants. Cochrane review En: The Cochrane Library, Issue 1.
[18.]
J.M. Moreno Villares.
Nutrición enteral y parenteral domiciliaria. Aspectos prácticos y normativa actual.
Acta Pediatr Esp, 56 (1998), pp. 9-16
[19.]
Consejo Interterritorial del Sistema Nacional de Salud.
Guía de práctica clínica de nutrición enteral domiciliaria.
[20.]
Orden Ministerial de 2 junio 1998 para la regulación de la nutrición enteral domiciliaria en el Sistema Nacional de Salud (Ref 98/13742).
pp. 19294-19296
[21.]
Orden Ministerial de 30 abril 1997 por la que se regulan los tratamientos dietoterápicos complejos (Ref 97/10409).
pp. 15047
[22.]
E. Vinnars, D. Wilmore.
History of parenteral nutrition.
J Parent Ent Nutr, 27 (2003), pp. 225-232
[23.]
D. Hansell.
Intravenous nutrition: the central or peripheral route.
Int Ther Clin Mon, 10 (1989), pp. 184-190
[24.]
H.J. Hellbock, P.A. Motchnick, B.N. Ames.
Toxic hydroperoxides in intravenous lipid emulsions used in preterm infants.
Pediatrics, 91 (1993), pp. 83-88
[25.]
P.A. Ball.
Intravenous in-line filters: filtering the evidence.
Curr Opin Clin Nutr Metab Care, 6 (2003), pp. 319-325
[26.]
K. Betune, M.C. Allwood, C. Granger, C. Wormleighton.
Use of filters during the preparation and administration of parenteral nutrition: position paper and guidelines prepared by a British Pharmaceutical Nutrition Group working party.
Nutrition, 17 (2001), pp. 403-408
[27.]
T.L. Hwang, M.C. Lue, L.L. Chen.
Early use of cyclic TPN prevents further deterioration of liver functions for the TPN with impaired liver function.
Hepatogastroenterology, 47 (2000), pp. 1347-1350
[28.]
L.A. Trissel.
Handbook of injectable drugs 8th ed.
[29.]
W. Schofield.
Predicting basal metabolic rate, new standards and review of previous work.
Hum Nutr Clin Nutr, 39 (1985), pp. 5-41
[30.]
J.A. Coss-Bu, W.J. Klish, D. Walding, F. Stein, E.O.B. Smith, L.S. Jefferson.
Energy metabolism, nitrogen balance, and substrate utilization in critically ill children.
Am J Clin Nutr, 74 (2001), pp. 664-669
[31.]
P.J. Porcelli, P.M. Sisk.
Increased parenteral amino acid administration to extremely low-birth. Weight infants during early postnatal life.
J Pediatr Gastroenterol Nutr, 34 (2002), pp. 174-179
[32.]
W. Heird.
Amino acids in pediatric and neonatal nutrition.
Curr Opin Clin Nutr Metab Care, 1 (1998), pp. 73-78
[33.]
J.A. Brunton, R.O. Ball, P.B. Pencharz.
Current total parenteral nutrition solutions for the neonate are inadequate.
Curr Opin Clin Nutr Metab Care, 3 (2000), pp. 299-304
[34.]
S.C. Kalhan, I. Kilic.
Carbohydrate as nutrient in the infant and child: range of acceptable intake.
Eur J Clin Nutr, 53 (1999), pp. S94-S100
[35.]
G.J. Schears, C.S. Deutschman.
Common nutritional issues in pediatric and adult critical care medicine.
Crit Care Clinic, 13 (1997), pp. 669-690
[36.]
G. Hardy, P. Ball, B. McElroy.
Basic principles for compounding all-in-one parenteral nutrition admixtures.
Curr Opin Clin Nutr Metab Care, 1 (1998), pp. 291-296
[37.]
R.J. Shulman, S. Phillips.
Parenteral nutrition in infants and children.
J Pediatr Gastroenterol Nutr, 36 (2003), pp. 587-697
[38.]
D.L. Burns, E.A. Mascioli, B.R. Bistrian.
Parenteral iron dextran therapy: a review.
Nutrition, 11 (1995), pp. 163-168
[39.]
B. Michael, D.W. Coyne, S. Fishbane, V. Folkert, R. Lynn, A.R. Nissenson, et al.
Sodium ferric gluconate complex in hemodialysis patients: adverse reactions compared to placebo and iron dextran.
Kidney Int, 61 (2002), pp. 1830-1839
[40.]
H.L. Greene, K.M. Hambidge, R. Schanler, R.C. Tsang.
Guidelines for the use of vitamins, trace elements, calcium, magnesium, and phosporus in infants and children receiving total parenteral nutrition: report of the Subcommittee on Pediatric Parenteral Nutrient Requirements from the Committee on Clinical Practice Issues of the American Society for Clinical Nutrition.
Am J Clin Nutr, 48 (1988), pp. 1324-1342
[41.]
G. Hardy, C. Reilly.
Technical aspects of trace element supplementation.
Curr Opin Clin Nutr Metab Care, 2 (1999), pp. 277-285
[42.]
A. Van Gossum, J. Neve.
Trace element deficiency and toxicity.
Curr Opin Nutr Metab Care, 1 (1998), pp. 499-507
[43.]
S. Suita, T. Yamanouchi, K. Masumoto, K. Ogita, M. Nakamura, S. Taguchi.
Changing profile of parenteral nutrition in pediatric surgery: a 30-year experience at one institute.
Surgery, 131 (2002), pp. S275-S282
[44.]
Puntis JWL.
Parenteral nutrition in infants.
Nutrition in the infant. Problems and practical procedures, pp. 79-91
[45.]
N.P. O'Grady, M. Alexander, E.P. Dellinger, J.L. Gerberding, S.O. Heard, D.G. Maki, et al.
Guidelines for the prevention of intravascular catheter-realted infections. Centers for Disease Control and Prevention.
MMWR Recomm Rep, 51 (2002), pp. 1-29
[46.]
J.M. Moreno Villares, P. Gomis Muñoz, L. Reyen, J. Manzanares López-Manzanares.
Nutrición parenteral domiciliaria en Pediatría.
An Esp Pediatr, 43 (1995), pp. 81-86
Copyright © 2004. Sociedad Española de Endocrinología y Nutrición
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