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首页> 外文期刊>BMC Pediatrics >Effectiveness of three commonly used transition phase diets in the inpatient management of children with severe acute malnutrition: a pilot randomized controlled trial in Malawi
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Effectiveness of three commonly used transition phase diets in the inpatient management of children with severe acute malnutrition: a pilot randomized controlled trial in Malawi

机译：三种常用的过渡期饮食在严重急性营养不良儿童的住院治疗中的有效性：马拉维的一项随机对照试验

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Background The case fatality rate of severely malnourished children during inpatient treatment is high and mortality is often associated with diarrhea. As intestinal carbohydrate absorption is impaired in severe acute malnutrition (SAM), differences in dietary formulations during nutritional rehabilitation could lead to the development of osmotic diarrhea and subsequently hypovolemia and death. We compared three dietary strategies commonly used during the transition of severely malnourished children to higher caloric feeds, i.e., F100 milk (F100), Ready-to-Use Therapeutic Food (RUTF) and RUTF supplemented with F75 milk (RUTF + F75). Methods In this open-label pilot randomized controlled trial, 74 Malawian children with SAM aged 6–60?months, were assigned to either F100, RUTF or RUTF + F75. Our primary endpoint was the presence of low fecal pH (pH?≤?5.5) measured in stool collected 3 days after the transition phase diets were introduced. Secondary outcomes were duration of hospital stay, diarrhea and other clinical outcomes. Chi-square test, two-way analysis of variance and logistic regression were conducted and, when appropriate, age, sex and initial weight for height Z-scores were included as covariates. Results The proportion of children with acidic stool (pH ≤5.5) did not significantly differ between groups before discharge with 30, 33 and 23% for F100, RUTF and RUTF + F75, respectively. Mean duration of stay after transitioning was 7.0?days (SD 3.4) with no differences between the three feeding strategies. Diarrhea was present upon admission in 33% of patients and was significantly higher (48%) during the transition phase ( p Conclusions This pilot trial does not demonstrate that a particular transition phase diet is significantly better or worse since biochemical and clinical outcomes in children with SAM did not differ. However, larger and more tightly controlled efficacy studies are needed to confirm these findings. Trial registration ISRCTN13916953 Registered: 14 January 2013.
机译：背景技术住院期间严重营养不良儿童的病死率很高，死亡率通常与腹泻有关。由于严重急性营养不良（SAM）中肠道碳水化合物的吸收受到损害，因此营养康复期间饮食配方的差异可能导致渗透性腹泻的发展，进而导致血容量不足和死亡。我们比较了严重营养不良的儿童向高热量饮食过渡期间通常使用的三种饮食策略，即F100牛奶（F100），即食治疗性食品（RUTF）和RUTF补充F75牛奶（RUTF + F75）。方法在这项开放标签的先导性随机对照试验中，将74位年龄在6-60个月的马拉维儿童SAM分为F100，RUTF或RUTF + F75。我们的主要终点是在引入过渡期饮食3天后粪便中测得的粪便pH低（pH≤≤5.5）。次要结果是住院时间，腹泻和其他临床结果。进行卡方检验，方差和逻辑回归的双向分析，并在适当的情况下，将年龄，性别和身高Z评分的初始体重作为协变量。结果出院前，酸性大便（pH≤5.5）的儿童比例在两组之间无显着差异，其中F100，RUTF和RUTF + F75分别为30％，33％和23％。过渡后的平均住院时间为7.0天（SD 3.4），三种喂养策略之间没有差异。入院时腹泻的发生率为33％，在过渡期明显增加（48％）（p结论）该初步试验并未证明特定过渡期饮食的生化和临床结局明显改善或恶化，因为SAM没什么不同，但是需要更大，更严格的疗效研究来证实这些发现，试验注册号为ISRCTN13916953，注册时间：2013年1月14日。

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