Browsing by Subject "Weight Gain"
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Item Diet, drugs, surgery: the skinny on weight reducing therapies(1997-04-03) Denke, Margo A.Item Item [Southwestern News](2005-12-01) Morales, KatherineItem [Southwestern News](2004-06-26) O'Brien, StephenItem Urine Sodium Concentration as a Marker of Poor Growth in Children with Intestinal Failure(2017-01-17) Casson, Cameron; Piper, Hannah; Pace, JesseBACKGROUND: Children who have had a significant small bowel resection often have difficulty growing adequately due to fluid and electrolyte losses in their stool. Specifically, growth is impaired when total body sodium depletion occurs. Urinary sodium concentration (UNa) is a more sensitive marker than serum sodium (less than or equal to 30 mmol/L considered low), and is used to monitor total body sodium status. The objective of this study was to determine the frequency of low UNa in children after significant bowel resection, and determine if it is associated with poor growth. METHODS: After IRB approval (Protocol #032016-015), a retrospective chart review of children (<19 years) who underwent small bowel resection (requiring parenteral nutrition for > 6 weeks post-operatively) cared for at Children's Health from 2010 to 2016 was performed. Patient characteristics, reason for small bowel resection, intestinal anatomy, nutritional intake, anthropometric measurements, and urine and serum electrolytes were collected. Z-scores were calculated from WHO and CDC standard growth charts. Anthropometric values were compared between children with a UNa less than or equal to 30 mmol/L and > 30 mmol/L. Statistical analysis was completed using Mann-Whitney and Pearson's correlation coefficient, providing both 95% confidence intervals and p-values. Analysis was performed with SAS 9.4 (Cary, NC). RESULTS: Thirty-eight children with significant bowel resection were included in the study. Patients had a median small bowel length of 50 cm (5-315 cm) and median % expected small bowel remaining of 27% (2-91%). The median UNa was 44 mmol/L, and 10 patients (26%) had a UNa less than or equal to, to 30 mmol/L. Only 1 patient demonstrated hyponatremia (serum Na = 130 meq/L). There was a positive correlation between UNa and both sodium intake (0.32, 95% CI [0.01, 0.57], p=.04), and body mass index (0.35, 95% CI [0.05, 0.60], p=.03), but no significant correlation with small bowel length. Children with UNa less than or equal to 30mmol/L had significantly lower Z-scores for weight (median -2.5 vs. -0.44, p=.0252) compared to those with UNa > 30mmol/L. CONCLUSION: Children with malabsorption after significant small bowel resection are at increased risk for sodium depletion and impaired growth. Patients with UNa less than or equal to 30 mmol/L should receive additional sodium supplementation to maximize growth.Item [UT Southwestern Medical Center News](2006-12-12) Despres, CliffItem [UT Southwestern Medical Center News](2009-01-28) McKenzie, AlineItem Weight Changes and Weight Measurements in Hospitalized Burn Patients(2017-01-17) Mendez-Romero, Denisse; Wolf, Steven E.; Clark, Audra T.; Phelan, Herb; Arnoldo, BrettINTRODUCTION: Burns are associated with significant changes in body weight due to resuscitation volumes leading to increased weight and a hypermetabolic state and prolonged bed rest resulting in wasting of lean body mass and weight loss. The actual weight changes and frequency of weight measurements throughout hospitalization have not been well described across time. The purpose of this study was to describe these in more detail. METHODS: A review was conducted of 232 thermally injured patients hospitalized in a large, ABA-verified burn center from February 2016 to September 2016. Patients were seen daily by a nutritionist and received tube or oral feeding as appropriate. Demographics, hospital length of stay, and all weight measurements were collected. RESULTS: Over 8 months, 232 burn patients were admitted. The mean (±SD) age was 33 ± 24 years, median TBSA was 7% (IQR 13-3) and men were 67.37% of the sample. Patients had a 4.92% ± 1.40% (mean ± SEM) increase in weight from baseline at hospital day 7(n=40). The mean weight changes of hospitalized patients were -1.57% ± 4.46% at 30 days (n=13), -6.66% ± 4.47% at 45 days (n=10), -13.83% ± 3.74% at 60 days (n=7), and -23.93% ± 12.26% at 130 days (n=2). The maximum length of stay was 205 days and this subject had a weight loss of 33.33% from baseline. Composite data of mean change of weight from baseline over time was plotted with an R2 value of 0.6 for both linear and third order regression. Patients with a length of stay between 7 to 14 days (n=49), 15 to 30 days (n=15), 31 to 60 days (n=9) and more than 60 days (n=9) had a daily weight recorded only 7.4%, 20.6%, 35.5% and 47% of their inpatient days, respectively. CONCLUSIONS: Burn patients demonstrate an increase in body weight within the first week of hospitalization likely related to resuscitation followed by a consistent decline. Patients with stays greater than one month have a decline in weight below their baseline and can lose as much as a third of their body mass even in the setting of nutritional support and rehabilitation efforts. Additionally, these data show that weight is measured more often as length of stay increases. Weight is often used as a marker of nutritional status, although this may not be appropriate in the setting of large fluid shifts and obesity. Additionally, patients might be losing muscle mass in favor of body fat. It is important to recognize long-term weight trends in the burn population, but further investigation is needed regarding the predictors of significant weight loss and associated outcomes.