Clinical Presentation of Malnourished Patients With Pneumonia Requiring Prolonged Ventilatory Support

Dina Johar, Andrew G. Day, Ekhard E. Ziegler

Abstract


Background: Prolonged exposure to oxygen during ventilatory support is likely to generate physiological abnormalities in the lungs of critically ill infants with bronchopneumonia. The induced physiological changes could impact the growth of young infants and could promote morbidity and mortality of susceptible patients. This article addresses the relationship of prolonged ventilation, severity of infection and type of feeding with growth of young infants and how this could promote morbidity and mortality of susceptible patients.

Methods: In this observational study, we assessed the clinical course of infectious pneumonia and its association with nutritional status, relative growth and lung functions of newborn and young infants with severe pneumonia requiring ventilatory support (group 1, N = 38). Patients were studied longitudinally to assess the association of weight and height z scores with blood proteins, ceruloplasmin and copper. Ventilated patients were compared with non-ventilated patients (group 2, N = 19) and healthy controls (C, N = 18).

Results: On admission, patients exhibited statistically lower blood protein, ceruloplasmin and copper levels compared to controls. Prolonged exposure to oxygen in G1 patients induced a steady state of hypoalbuminemia compared to zero time. The groups differed with regard to growth characteristics, with patients in G1 tending to have lower z scores for weight and height than group 2 and controls. Recurrent infection rates and duration of ventilation were consistently worse among patients with indicators of malnutrition.

Conclusion: Patients who administered supplemental oxygen via mechanical ventilation tended to have poorer nutritional status than patients who have not been ventilated and healthy controls.




Int J Clin Pediatr. 2016;5(2):19-28
doi: http://dx.doi.org/10.14740/ijcp249w


Keywords


Pneumonia; Weight for height z score; Height for age z score; Weight for age z score; Mechanical ventilation; Under-five mortality

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International Journal of Clinical Pediatrics, quarterly, ISSN 1927-1255 (print), 1927-1263 (online), published by Elmer Press Inc.                     
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