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Utilization of a Nutrition Support Algorithm Reduces Unnecessary Parenteral Nutrition Use in Pediatric Oncology Inpatients

Published:January 29, 2016DOI:https://doi.org/10.1016/j.jand.2015.12.007
      Adequate nutrition is critical for children with cancer. Although pediatric cancer continues to be a fairly common diagnosis (with one in 285 children falling ill before the age of 20 years), advances in treatment have resulted in significantly improved 5-year survival rates of nearly 80% today.
      • Ward E.
      • DeSantis C.
      • Robbins A.
      • Kohler B.
      • Jemal A.
      Childhood and adolescent cancer statistics.
      However, these children are at increased risk for malnutrition. According to the literature, the rate of malnutrition in this population ranges from less than 10% to up to 50%.
      • Bauer J.
      • Jurgens H.
      • Fruhwald M.
      Important aspects of nutrition in children with cancer.
      • Ladas E.
      • Sacks N.
      • Meacham L.
      • et al.
      A multidisciplinary review of nutrition considerations in the pediatric oncology population: A perspective from children’s oncology group.
      • Sacks N.
      • Henry D.
      • Bunger K.
      • et al.
      Oncology, hematopoietic transplant, gastrointestinal supportive care medications, and survivorship.
      Children commonly lose weight before diagnosis, placing them at high risk nutritionally before even initiating treatment.
      • Ladas E.
      • Sacks N.
      • Meacham L.
      • et al.
      A multidisciplinary review of nutrition considerations in the pediatric oncology population: A perspective from children’s oncology group.
      • Sacks N.
      • Henry D.
      • Bunger K.
      • et al.
      Oncology, hematopoietic transplant, gastrointestinal supportive care medications, and survivorship.
      • Bozzetti F.
      • Arends J.
      • Lundholm K.
      • et al.
      ESPEN Guidelines on Parenteral Nutrition: Non-surgical oncology.
      They also may have increased metabolic demands because of their disease or from treatment methods such as chemotherapy, radiation, surgery, and bone marrow transplantation.
      • Sacks N.
      • Henry D.
      • Bunger K.
      • et al.
      Oncology, hematopoietic transplant, gastrointestinal supportive care medications, and survivorship.
      • Sala A.
      • Pencharz P.
      • Barr R.
      Children, cancer, and nutrition: A dynamic triangle in review.
      Furthermore, treatment side effects, including nausea, vomiting, mucositis, anorexia, taste changes, and typhlitis, may impact the ability to meet these demands with oral intake alone.
      • Sacks N.
      • Henry D.
      • Bunger K.
      • et al.
      Oncology, hematopoietic transplant, gastrointestinal supportive care medications, and survivorship.
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