Changes in nutritional status in children with community-acquired pneumonia: new opportunities for diagnosis and correction
https://doi.org/10.51793/OS.2022.25.1.003
Abstract
A change in the nutritional status both towards a lack of mass and towards an excess is a factor in the unfavorable course and outcomes of acute infectious diseases. Protein-energy deficiency affects the immune response, altering the body's defense processes. Several studies have shown that the relationship between infection and malnutrition is bi-directional. Obesity also impairs the immune response. An important aspect of the development of nutritional status disorders in patients with acute infectious diseases is the combined lesion of the respiratory and gastrointestinal tract organs. We carried out a study of body composition by bioimpedansometry in 12 children in the febrile period of acute respiratory infection of bacterial etiology (hospitalized with community-acquired pneumonia), as well as in 16 clinically healthy children from 4 to 11 years old. Body fat mass, active cell mass and child's weight were assessed. In conventionally healthy children, ACM and иody fat mass corresponded to the norm. In children with pneumonia, upon admission to the hospital, a decrease in active cell mass was observed in more than 80% of cases, active cell mass by the time of discharge was normal in half of the examined patients. Clinical examples of changes in the nutritional status established on the basis of bioimpedansomerism in children hospitalized with community-acquired pneumonia are described. Thus, for the first time, we conducted a pilot study of body composition in children with acute respiratory diseases of bacterial etiology, which demonstrated the greatest severity of changes in protein metabolism. On the basis of this, a correction of protein deficiency has been proposed by adding a dry product of preventive dietary food for children 1-10 years old to the children's diet.
About the Authors
S. P. KremplevskayaРоссия
Sofia P. Kremplevskaya, pediatrician in the Pediatric Department for Infectious Diseases of Khimki Hospital; PhD student in the Clinical Department of Infectious Pathology at the Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being
11 Kurkinskoe highway, Khimki, 141407,
3a Novogireevskaya str., Moscow, 111123
A. D. Muzyka
Россия
Аnna D. Muzyka, MD, PhD, Senior researcher of the Clinical Department of Infectious Diseases
3a Novogireevskaya str., Moscow, 111123
V. I. Barykin
Россия
Vadim I. Barykin, Head of Pediatric Department for Infectious Diseases
11 Kurkinskoe highway, Khimki, 141407
E. V. Melekhina
Россия
Elena V. Melekhina, Dr. of Sci. (Med.), Associate Professo of Pediatrics, Leading researcher of the Clinical Department of Infectious Diseases at the Clinical Department of Infectious Diseases at the Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being
3a Novogireevskaya str., Moscow, 111123
References
1. Borelli P., Blatt S. L., Rogero M. M., Fock R. A. Haematological alterations in protein malnutrition // Rev. Bras. Hematol. Hemoter. 2004; 26: 49-56.
2. Brown K. H. Dietary management of acute diarrheal disease: Contemporary scientific issues // J. Nutr. 1994. 124. 1455S-1460S.
3. Brown K. H. Diarrhea and malnutrition // J. Nutr. 2003; 133: 328S-332S.
4. Rodríguez L., Cervantes E., Ortiz R. Malnutrition and gastrointestinal and respiratory infections in children: a public health problem // Int. J. Environ. Res. Public Health. 2011; 8 (4): 1174-205. doi: 10.3390/ijerph8041174.
5. Schaible U. E., Kaufmann S. HE. Malnutrition and infection: Complex mechanisms and global impacts // PLoS Med. 2007. 4. e115.
6. Bloss E., Wainaina F., Bailey R.C. Prevalence and predictors of underweight, stunting, and wasting among children aged 5 and under in Western Kenya, Bailey // J. Trop. Pediatr. 2004. 50. 260-270.
7. Cunningham-Rundles S., McNeeley F.D., Moon A. Mechanisms of nutrient modulation of the immune response // J. Allergy Clin. Immunol. 2005. 115. 1119-1128.
8. Wilmore D. W. Infection and Injury: Effects on Whole Body Protein Metabolism. In: Committee on Military Nutrition Research, Institute of Medicine, editor. Protein and Amino Acids. Washington, DC, USA: National Academic Press, 1999. pp. 155-167.
9. Powanda M. C., Beisel W. R. Metabolic effects of infection on protein and energy status // J. Nutr. 2003. 133. 322S-327S.
10. Metabolic effects of acute measles in chronically malnourished Nigerian children / R. S. Phillips, C. O. Enwonwu, S. Okolo, A. J. Hassan // Nutr. Biochem. 2004. 15. 281-288.
11. Protein energy malnutrition decreases immunity and increases susceptibility to influenza infection in mice / A. K. Taylor, W. Cao, K. P. Vora, J. De La Cruz, W. J. Shieh, S. R. Zaki, J. M. Katz, S. Sambhara, S. Gangappa // J. Infect Dis. 2013. 207. 501-510. doi: 10.1093/infdis/jis527
12. Effect of nutritional status on the course and outcomes of acute respiratory infections in children affecting the lower respiratory tract / S. P. Kremplevskaya, A. D. Muzyka, E. V. Melekhina [et al.] Russian Medical Inquiry. 2020;4(11):691-697. DOI: 10.32364/2587-6821-2020-4-11-691-697. (In Russian)
13. Rudnev S. G., Soboleva N. P., Sterlikov S. A. Bioimpedance research of the body structure of the Russian population. Moscow, 2014. 493 p. (In Russian)
14. Gaivoronsky I. V., Nichiporuk G. I., Gaivoronsky I. N., Nichiporuk N. G. Bioimpedance measurement as a method for assessing the component composition of the human body (literature review) // Vestnik SanktPeterburgskogo universiteta. Meditsina. 2017; 4 (12): 365-384. DOI 10.21638/11701/spbu11.2017.406.
15. Martirosov E. G., Nikolaev D. V., Rudnev S. G. Technologies and methods of definition of the body structure. Moscow, Nauka Publ., 2006. 248 p. (In Russian)
16. Comprehensive metabolic amino acid flux analysis in critically ill patients / N. EP. Deutz, P. Singer, R. A. Wierzchowska-McNew, M. V. Viana, I. A. Ben-David, O. Pantet, J. J. Thaden, G. AM. Ten Have, MP. KJ. Engelen, M. M. Berger // Clin Nutr. 2021. 40(5). 2876-2897. doi: 10.1016/j.clnu.2021.03.015.
Review
For citations:
Kremplevskaya S.P., Muzyka A.D., Barykin V.I., Melekhina E.V. Changes in nutritional status in children with community-acquired pneumonia: new opportunities for diagnosis and correction. Lechaschi Vrach. 2022;(1):18-24. (In Russ.) https://doi.org/10.51793/OS.2022.25.1.003
JATS XML



















