Estado nutricional de pacientes pediátricos ostomizados

Abstract

Objective: To assess the nutritional status of children submitted to ostomy for intestinal discharge.Methods: A descriptive case series was carried out including 30 children aged up to ten years old submitted to colostomy or ileostomy at the pediatric surgery unit of Institute of Medicine Professor Fernando Figueira, Recife, Pernambuco. Socioeconomic, clinical, anthropometric, and laboratorial (hemoglobin and hematocrit) data were collected using a structured questionnaire. Nutritional status was determined based on anthropometric indicators (height/age, weight/age, and body mass index/age), which were stratified by gender, with World Health Organization standards as reference. Arm circumference and triceps skinfold were measured for the evaluation of body composition. Chest and head perimeters were measured on children aged up to five years-old. The Student's t-test was applied to compare two independent groups, considering p<0.05 as significant.Results: All anthropometric indicators revealed nutritional deficit, especially in the height/age index, which revealed a frequency of 24.1% of short statue. Patients submitted to ileostomy presented lower mean Z score of anthropometric indicators, hemoglobin, hematocrit and ostomy time in comparison to those submitted to colostomy, with significant differences only for the Z score of body mass index/age (p=0.016), hemoglobin (p=0.025), and hematocrit (p=0.023). Conclusions:There is a substantial frequency of nutritional deficit in the analyzed sample, especially based on the height/ age index. Although ileostomized patients had less time of ostomy, they had higher nutritional deficit compared to the colostomized ones, likely due to greater risk of postoperative complications, with consequent nutritional impairment.Key-words: ostomy; nutritional status; child. RESUMO Objetivo:Avaliar o estado nutricional de crianças portadoras de ostomia de eliminação intestinal.Métodos: Realizou-se um estudo descritivo, tipo série de casos, com amostra composta por 30 crianças menores de dez anos, portadoras de colostomia ou ileostomia, admitidas na clínica cirúrgica pediátrica do Instituto de Medicina Integral Professor Fernando Figueira, no Recife, em Pernambuco. Foi utilizado um questionário estruturado para coletar dados socioeconômicos, clínicos, antropométricos e laboratoriais (hemoglobina e hematócrito). O diagnóstico nutricional foi realizado a partir dos indicadores antropométricos (altura/idade, peso/idade e índice de massa corpórea/idade), tomando-se como base o padrão de referência da Organização Mundial da Saúde. Também foram aferidas a circunferência do braço e a prega cutânea tricipital para avaliar a composição corporal, bem como os perímetros torácico e cefálico em crianças menores de cinco anos. Resultados: Encontrou-se comprometimento nutricional importante de acordo com os indicadores antropométri-cos estudados, destacando-se o déficit estatural (24,1%). Os pacientes ileostomizados apresentaram menores médias de escore Z dos indicadores antropométricos, hemo...

Characterization of children and teenagers with ostomies in a health service

“…With regard to the type of stoma, a colostomy was the most frequent. These results are similar to other studies with children with ostomies in which colostomy occurred more frequently 10,[12][13][14][17][18][19][20][21][22][23][24] . It is worth noting in the literature the existence of other studies in pediatrics that show the predominance of urostomy, gastrostomy, and even ileostomy 10,14 .…”

“…W ith regard to family income, there was a predominance of people with a family income between one and two minimum wages (47.3%). These results coincide with those of other surveys of the profile of people with ostomies in which the family income prevailed below three minimum wages 2,5,12,14 congenital malformations 8,10,12,17,21 . Considering the intestinal stomies, there was a greater frequency of anorectal anomaly.…”

“…As for the format, the round ostomies predominated 3). finding, research with children and adolescents with ostomies showed families with per capita income lower than a minimum wage 12,17 . The income information allows concluding that the population studied has low purchasing power, which makes it difficult to acquire adequate collecting devices for the type of stomies, as well as the adjuvant accessories.…”

“…As for gastrointestinal tract diseases resulting in the manufacture of ostomies, the literature shows that there is variation in the age group between children and adolescents, being common the occurrence from the first days of life until adolescence, but it occurs with greater prevalence in the age group between zero and five years 9,16,17 .…”

Assessment of nutritional status of patients of congenital pouch colon following definitive surgery

“…This is significant as the terminal ileum is important for absorption of Vitamin B 12, bile salts , fat, and the fat-soluble vitamins. In addition, patients with CPC undergo multiple surgeries and as shown by a study of children subjected to ostomy (ileostomy/colostomy) procedures,[18] multiple surgeries and their complications, both early and late, can directly or indirectly influence nutritional status. All these problems are less severe with Types III-IV CPC.…”