ASSESSMENT OF NUTRITIONAL STATUS AND FREQUENCY OF COMPLICATIONS ASSOCIATED TO FEEDING IN PATIENTS WITH SPASTIC QUADRIPLEGIC CEREBRAL PALSY

[Article in Portuguese, English]

Kamilla Tavares de Sousa et al. Rev Paul Pediatr. 2020.

Abstract

in English, Portuguese

Objective: To correlate the nutritional status with variables associated to the type of diet and feeding route of children and adolescents with spastic quadriplegic cerebral palsy (CP).

Methods: This cross-sectional study included 28 patients aged ≤13 years old who presented a diagnosis of spastic quadriplegic CP and were followed by the nutrition team of the Outpatient Clinic for Special Patients of Hospital de Clínicas de Uberlandia - Universidade Federal de Uberlandia (HC-UFU), between July/2016 and January/2017. Consent forms were signed by the legal guardians. The nutritional status was evaluated and data on dietary complications food route and type of diet were collected. For the description of data, average and median values were used. Correlation was tested with Spearman's index. Significance was set at p<0.05.

Results: 75% of patients used alternative feeding routes (nasoenteral, catheter or gastrostomy), 57% were eutrophic. The most frequent complications were oropharyngeal dysphagia, reflux and intestinal constipation. No correlation was found between the occurrence of complications and the nutritional status. There was a positive correlation between the diet received and the patient's nutritional status (0.48; p=0.01), i.e. individuals with adequate caloric and macronutrients intake had a better nutritional status.

Conclusions: The results reinforce the need for continued nutritional guidance for the children's parents/caregivers, as well as the choice of an adequate rout of feeding to each child by the multi-professional team, in order to contribute to improved nutritional status and adequate dietary intake.

Objetivo:: Correlacionar o estado nutricional com variáveis associadas ao tipo de dieta e via de alimenta??o de crian?as e adolescentes com paralisia cerebral (PC) tetraparética espástica.

Métodos:: Estudo de corte transversal com 28 pacientes com idade ≤13 anos, atendidos pela equipe de nutri??o do Ambulatório de Pacientes Especiais do Hospital de Clínicas de Uberlandia da Universidade Federal de Uberlandia (HC-UFU), entre julho de 2016 e janeiro de 2017, que apresentavam diagnóstico de PC tetraparética espástica. Os pacientes incluídos tiveram o termo de consentimento assinado pelo responsável legal. Avaliou-se o estado nutricional e coletaram-se dados sobre complica??es alimentares, via de alimenta??o e tipo de dieta. Para descri??o desses dados, foram utilizadas média e mediana; para análises de correla??o, correla??o de Spearman, sendo significante p<0,05.

Resultados:: Neste estudo, 75% dos pacientes utilizavam via alternativa para alimenta??o (sonda nasoenteral ou gastrostomia) e 57% eram eutróficos. As complica??es mais frequentes foram disfagia orofaríngea, refluxo e obstipa??o intestinal. N?o houve correla??o entre ocorrência de complica??es e estado nutricional. Observou-se correla??o positiva entre dieta recebida e estado nutricional dos pacientes (0,48; p=0,01), sendo que indivíduos com adequada ingest?o calórica e de macronutrientes apresentaram melhor classifica??o do estado nutricional.

Conclus?es:: Os resultados obtidos refor?am a necessidade de orienta??es nutricionais contínuas para os pais/cuidadores das crian?as do estudo, bem como a escolha de uma via de alimenta??o adequada a cada uma delas pela equipe multiprofissional, a fim de contribuir para a melhora do estado nutricional e da ingest?o alimentar.

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Conflict of interest statement

The authors declare no conflict of interests.

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