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首页> 外文期刊>Kidney Research and Clinical Practice >THINKING OUTSIDE THE SQUARE: NUTRITION SUPPORT IN 18 YR OLD WITH CHRONIC RENAL FAILURE, GASTRECTOMY AND COLECTOMY USING A PAEDIATRIC FORMULA.
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THINKING OUTSIDE THE SQUARE: NUTRITION SUPPORT IN 18 YR OLD WITH CHRONIC RENAL FAILURE, GASTRECTOMY AND COLECTOMY USING A PAEDIATRIC FORMULA.

机译：在方格之外思考：18岁儿童的营养支持，使用小儿配方，可预防慢性肾功能衰竭，胃镜检查和胆囊切除。

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18 yr old female with EBV lymphoproliferative disorder, B cell lymphoma on background of Crohn's disease, sclerosing cholangitis/autoimmune hepatitis overlap underwent total colectomy and gastrectomy due to life-threatening bleeds. During her 132 day PICU stay, she lost 14kg (23% body weight) and developed CRF. Energy requirements were estimated using Schofield Equation, ideal body weight for height, light activity. Several formulae were compared for total energy, goal rate (jejunal feeds without a colon), osmolality, protein allowance and micronutrient requirements for an 18 yr old female. No adult formulae were suitable in this case. Initially, diluted Suplena^T^M (1.7kCal/ml) was used, but weight gain was too rapid and protein intake too low (0.7g/kg/d). Nutrini Energy^T^M (1.5kCal/ml) met requirements for: energy, protein (~1g/kg), micronutrients (except K, Mg and P [see table]). Feed rate (90ml/hr) was well-tolerated; stool output remained 200-300ml/day. Feeds were given over 16/24 for flexibility. Skinfold measures (TSF, MAC) were 25^t^h-50^t^h percentile and she reached goal weight in 4 months. NutrientIntake% RDINutrient% RDIEnergy kJ/kCal9030/216098-102Vitamin A eq125Protein g5998-101Thiamin301Fluid (mL)2000100Riboflavin314Na (mmol)76282 (AI)Niacin eq175K(mmol)6191 (AI)*Vitamin B12162Ca (mg)1296100Vitamin C540Mg (mg)24582*I144P (mg)108086*Mo201Fe (mg)21.6144Se108 This patient's clinical complexity made meeting nutritional needs very challenging. Serum Mg levels remained normal, and due to CRF, P and K less than RDI is appropriate. A paediatric formula met adult needs in this unique case: low protein, high energy, and adult micronutrient RDIs.
机译：18岁女性患有EBV淋巴增生性疾病，克罗恩氏病背景下的B细胞淋巴瘤，硬化性胆管炎/自身免疫性肝炎重叠，由于严重的出血导致接受了全结肠切除术和胃切除术。在PICU住院132天期间，她体重减轻了14kg（体重23％）并发展为CRF。使用Schofield方程，高体重的理想体重，轻度活动来估算能量需求。比较了18岁女性的总能量，目标速率（无结肠的空肠饲料），重量克分子渗透压浓度，蛋白质允许量和微量营养素需求量的几个公式。在这种情况下，不适合使用成人配方奶粉。最初，使用稀释的Suplena ^ T ^ M（1.7kCal / ml），但体重增加过快且蛋白质摄入过低（0.7g / kg / d）。 Nutrini Energy ^ T ^ M（1.5kCal / ml）满足以下方面的要求：能量，蛋白质（〜1g / kg），微量营养元素（钾，镁和磷除外）（请参见表）。进料速度（90毫升/小时）耐受良好;大便排出量保持在200-300ml /天。出于灵活性考虑，进给率超过16/24。皮褶测量（TSF，MAC）为25 ^ t ^ h-50 ^ t ^ h百分位数，她在4个月内达到目标体重。营养摄入％RDIN营养％RDI能量kJ / kCal9030 / 216098-102维生素A eq125蛋白质g5998-101硫胺301液体（mL）2000100核黄素314 Na（mmol）76282（AI）烟酸eq175K（mmol）6191（AI）*维生素B12162100 mg（mg） I144P（mg）108086 * Mo201Fe（mg）21.6144Se108该患者的临床复杂性使得满足营养需求非常困难。血清Mg水平保持正常，由于CRF，P和K低于RDI是适当的。在这种独特的情况下，儿科配方奶粉可以满足成人的需求：低蛋白，高能量和成人微量营养素RDI。

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