Nutrition and fluid therapy
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie in Bailey & Love's Short Practice of Surgery, 2018
A simple method of assessing nutritional status is to estimate weight loss. Measured body weight is compared with ideal body weight obtained from tables or from the patient’s usual or premorbid weight. Unintentional weight loss of more than 10% of a patient’s weight in the preceding 6 months is a good prognostic indicator of poor outcome. Body weight is frequently corrected for height, allowing calculation of the body mass index (BMI, defined as body weight in kilograms divided by height in metres squared). A BMI of less than 18.5 indicates nutritional impairment and a BMI below 15 is associated with significant hospital mortality. Major changes in fluid balance, which are common in critically ill patients, may make body weight and BMI unreliable indicators of nutritional status.
Children with feeding difficulties: medical and nursing perspectives
Southall Angela in Feeding Problems in Children, 2017
The term FTT refers to the state of inadequate growth from inability to obtain and/ or use calories required for growth. It is a symptom, not a disease, but regardless of the aetiology, all children failing to thrive have malnutrition (Hoare, 2009). FTT has no universal definition, although one of the most common parameters is weight and sometimes height. Percentile charts are routinely used for all children accessing healthcare and constitute an efficient opportunity to identify children who may be failing to thrive. Although definitions vary, most authors use this term only when growth has been noted to be low or to have decreased over time. For instance, some authors define FTT as a height or weight of less than the third to fifth percentiles for age on more than one occasion. Other authors cite height or weight measurements falling 2 major percentile lines using the standard growth charts of the National Center for Health Statistics (NCHS). Still others state that true malnutrition (weight <80% of ideal body weight for age) should be present to state a child is failing to thrive.
Assessment – Macronutrient Needs and Oral Intake
Jennifer Doley, Mary J. Marian in Adult Malnutrition, 2023
Protein needs in critically ill patients are higher than in their non-critically ill peers to account for increased protein catabolism and decreased protein synthesis during periods of acute illness.12 ASPEN describes protein in the critically ill as the most vital macronutrient for preservation of LBM, supporting immune function, and healing wounds.12 Protein requirements are based on BMI with the use of either actual or ideal body weight. Exceptions to this recommendation include patients with cirrhosis, hepatic failure, or other comorbidities leading to fluid retention; in these cases an estimated dry weight should be used to calculate protein needs.12BMI < 30: 1.2–2 g/kg actual body weightBMI 30–40: 2 g/kg ideal body weightBMI > 40: 2–2.5 g/kg ideal body weight
Allometric scaling of therapeutic monoclonal antibodies in preclinical and clinical settings
Published in mAbs, 2021
Eva Germovsek, Ming Cheng, Craig Giragossian
Instead of scaling the dose directly, approaches (outlined above), such as population PK modeling with allometric scaling or PBPK modeling should be used to match safe and effective mAb exposures observed in the adult patients.1,6–8,57,94,101 Additionally, when designing a dosing regimen for younger pediatric patients (e.g., <2 years), accounting for maturation is warranted,6,9,33,75 albeit the evidence is currently still limited. The modeling approaches are also suggested by the regulatory authorities, and consequently often used nowadays in the pediatric studies.3,4,15 Furthermore, using modeling and simulation can be helpful in designing optimal sampling schemes, which is particularly important for pediatric patients, who can only provide a limited number of samples;153 and can be useful for mAbs with nonlinear elimination due to TMDD.106 Other body size descriptors, such as ideal body weight, might also be considered, to account for some variability between patients who are over- or underweight.149,154
The effect of obesity on human reproductive health and foetal life
Published in Human Fertility, 2022
Serap Incedal Irgat, Hande Bakirhan
The desire to have children is powerful and widespread, but for a sizeable minority, such a desire is not easily fulfilled. Challenges to fertility arise from genetic abnormalities, infectious or environmental agents, delayed childbearing, behaviour, and certain diseases. Modifiable factors, including obesity, contribute to the burden of infertility. Ideal body weight has been found to prevent the public health problem of infertility. According to the literature, the reproductive system is adversely affected by increasing BMI. Obesity has often been associated with ovulatory and menstrual dysfunction and subsequent infertility, the increased risk of miscarriage, and the decreased effectiveness of assisted reproduction techniques. Obesity is also responsible for sperm DNA fragmentation. It affects semen parameters as well as sperm morphology and motility through various mechanisms in males, and it is a potential risk for infertility via ovulatory disorders in females. Obesity has also been associated with infertility as well as increased pregnancy loss. Various interventions, including healthy eating behaviours and weight management strategies, can be a key solution to reducing the infertility rate associated with obesity. Healthy, balanced, and adequate nutrition is as important for healthy embryo development or sperm formation and the continuity of foetal life.
Body Mass Index (BMI) and Infectious/Febrile Episodes in Children with Intermediate Risk Acute Lymphoblastic Leukemia (IR ALL)
Published in Nutrition and Cancer, 2019
Radosław Chaber, Elżbieta Latos-Grażyńska, Krzysztof Ciebiera, Kornelia Łach, Barbara Tokar, Józef Cebulski, Katarzyna Trybucka, Artur Mazur
Good nutritional support seems to be essential for infection prevention in the pediatric oncology population. Unfortunately, there have not been many studies evaluating the influence of proper nutrition on infection rates in children with cancer during chemotherapy. Nutritional status can be assessed by several different anthropometric parameters such as weight, length or height for age, body mass index (BMI), ideal body weight (IBW), and triceps skin fold measurement (25–27). BMI, as a measure easy to obtain, is largely not only used for the definition of obesity in children because it correlates well with body fat (28) and cardiovascular risk factors (29,30) but also has some limitations, for example, it does not differentiate between fat mass and fat-free mass (31,32). According to the Children’s Oncology Group (COG) nutrition committee review, the categorization of malnutrition into underweight and overweight and subsequent nutritional intervention should be based on either ideal body weight or BMI (33).
Related Knowledge Centers
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- Weighing Scale
- Parent
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- Olympic Weightlifting
- Powerlifting