Abstract：
BACKGROUND: Neurological impairment (NI) relates to disorders of the central nervous system. The specific aetiology of NI varies but includes genetic, congenital abnormalities or brain injury. In children with severe NI, feeding impairments can lead to undernutrition, and some children require a feeding tube. Although tube feeding improves overall nutritional status, it has also been associated with excess body fat. Commercially available enteral formulas that are low in energy, hydrolysed and nutritionally adequate for protein and micronutrients are available to mitigate gastrointestinal symptoms and obesity.
METHODS: This is a retrospective multicentre study of children who attended NI clinics between January 2022 and July 2023. Data were collected before and 1 month after receiving a low-energy, partially hydrolysed enteral formula (0.6 kcal/mL) on demographic data (age, sex, ethnicity and NI diagnosis), anthropometric measurements (weight, height, weight-for-age Z-score, height-for-age Z-score, body mass index [BMI] Z-score) and feed regimen (feed volume, total fluids and type of formula/supplements).
RESULTS: Dietitians collected data on 28 children, the median age was 7 years (interquartile range [IQR] 3, 8). The most frequently recorded NI was cerebral palsy, in 13 of 28 children (48%). Before the formula switch, the most frequently reported gastrointestinal symptom was constipation, in 13 of 28 children. Within 1 month of switching to a low-energy, hydrolysed formula, 10 of the 13 (77%) children reported an improvement in constipation. Before the formula switch, all 28 children were experiencing excessive weight gain. After the formula was switched to low-energy, hydrolysed formula, dietitians reported that 20 of the 28 (76%) children\'s weight either stabilised or reduced after 1 month. There was no statistically significant difference in weight-for-age Z-score or BMI Z-scores postswitch of formula (p-value 0.1 and 0.09, respectively). Fibre intake increased significantly from 3.3 to 8.1 g/day (p-value < 0.01) after formula switch. The number of children whose feed regimens were simplified after switching to a low-energy, partially hydrolysed formula was 24 of 28 (91%).
CONCLUSIONS: Children with an NI who have gastrointestinal symptoms may benefit from a low-energy, hydrolysed enteral formula to maximise feed tolerance and promote healthy weight gain. In addition, changing to a low-energy, hydrolysed formula may simplify feed regimens by eliminating the need for additional electrolytes, multivitamins and fluid boluses. Healthcare professionals should be knowledgeable about the effectiveness and availability of a low-energy, hydrolysed formula.
METHODS: This is a retrospective multicentre study of children who attended NI clinics between January 2022 and July 2023. Data were collected before and 1 month after receiving a low-energy, partially hydrolysed enteral formula (0.6 kcal/mL) on demographic data (age, sex, ethnicity and NI diagnosis), anthropometric measurements (weight, height, weight-for-age Z-score, height-for-age Z-score, body mass index [BMI] Z-score) and feed regimen (feed volume, total fluids and type of formula/supplements).
RESULTS: Dietitians collected data on 28 children, the median age was 7 years (interquartile range [IQR] 3, 8). The most frequently recorded NI was cerebral palsy, in 13 of 28 children (48%). Before the formula switch, the most frequently reported gastrointestinal symptom was constipation, in 13 of 28 children. Within 1 month of switching to a low-energy, hydrolysed formula, 10 of the 13 (77%) children reported an improvement in constipation. Before the formula switch, all 28 children were experiencing excessive weight gain. After the formula was switched to low-energy, hydrolysed formula, dietitians reported that 20 of the 28 (76%) children\'s weight either stabilised or reduced after 1 month. There was no statistically significant difference in weight-for-age Z-score or BMI Z-scores postswitch of formula (p-value 0.1 and 0.09, respectively). Fibre intake increased significantly from 3.3 to 8.1 g/day (p-value < 0.01) after formula switch. The number of children whose feed regimens were simplified after switching to a low-energy, partially hydrolysed formula was 24 of 28 (91%).
CONCLUSIONS: Children with an NI who have gastrointestinal symptoms may benefit from a low-energy, hydrolysed enteral formula to maximise feed tolerance and promote healthy weight gain. In addition, changing to a low-energy, hydrolysed formula may simplify feed regimens by eliminating the need for additional electrolytes, multivitamins and fluid boluses. Healthcare professionals should be knowledgeable about the effectiveness and availability of a low-energy, hydrolysed formula.
摘要：
背景：神经损伤（NI）涉及中枢神经系统的疾病。NI的具体病因各不相同，但包括遗传，先天性异常或脑损伤。在患有严重NI的儿童中，进食障碍会导致营养不良，有些孩子需要喂食管。虽然管饲改善了整体营养状况，它也与身体脂肪过多有关。市售肠内配方，能量低，水解和营养充足的蛋白质和微量营养素可用于减轻胃肠道症状和肥胖。
方法：这是一项针对2022年1月至2023年7月期间在NI诊所就诊的儿童的回顾性多中心研究。数据收集之前和接受低能量，人口统计数据上的部分水解肠内配方(0.6千卡/毫升)(年龄，性别,种族和NI诊断），人体测量（体重，高度,年龄体重Z评分，身高年龄Z分，体重指数[BMI]Z评分)和饲料方案(饲料量，总液体和配方/补充剂的类型)。
结果：营养师收集了28名儿童的数据，中位年龄为7岁(四分位距[IQR]3,8).最常记录的NI是脑瘫，28名儿童中有13名（48%）。在公式转换之前，最常见的胃肠道症状是便秘，28个孩子中的13个。在切换到低能耗的1个月内，水解配方，13名儿童中有10名（77%）报告便秘有所改善。在公式转换之前，所有28名儿童都经历了过多的体重增加.配方切换到低能量后，水解配方，营养师报告说，28名儿童中有20名（76%）的体重在1个月后稳定或减少。公式转换后，年龄体重Z评分或BMIZ评分无统计学差异（p值分别为0.1和0.09）。配方转换后，纤维摄入量从3.3g/天显着增加到8.1g/天（p值<0.01）。改用低能量喂养后简化喂养方案的儿童数量，部分水解的配方是28个中的24个(91%)。
结论：有胃肠道症状的NI患儿可能会从低能量治疗中获益，水解肠内配方，以最大限度地提高饲料耐受性和促进健康的体重增加。此外,换成低能耗的，水解配方可以通过消除对额外电解质的需求来简化饲料方案，多种维生素和液体丸剂。医疗保健专业人员应该了解低能耗的有效性和可用性，水解配方。
方法：这是一项针对2022年1月至2023年7月期间在NI诊所就诊的儿童的回顾性多中心研究。数据收集之前和接受低能量，人口统计数据上的部分水解肠内配方(0.6千卡/毫升)(年龄，性别,种族和NI诊断），人体测量（体重，高度,年龄体重Z评分，身高年龄Z分，体重指数[BMI]Z评分)和饲料方案(饲料量，总液体和配方/补充剂的类型)。
结果：营养师收集了28名儿童的数据，中位年龄为7岁(四分位距[IQR]3,8).最常记录的NI是脑瘫，28名儿童中有13名（48%）。在公式转换之前，最常见的胃肠道症状是便秘，28个孩子中的13个。在切换到低能耗的1个月内，水解配方，13名儿童中有10名（77%）报告便秘有所改善。在公式转换之前，所有28名儿童都经历了过多的体重增加.配方切换到低能量后，水解配方，营养师报告说，28名儿童中有20名（76%）的体重在1个月后稳定或减少。公式转换后，年龄体重Z评分或BMIZ评分无统计学差异（p值分别为0.1和0.09）。配方转换后，纤维摄入量从3.3g/天显着增加到8.1g/天（p值<0.01）。改用低能量喂养后简化喂养方案的儿童数量，部分水解的配方是28个中的24个(91%)。
结论：有胃肠道症状的NI患儿可能会从低能量治疗中获益，水解肠内配方，以最大限度地提高饲料耐受性和促进健康的体重增加。此外,换成低能耗的，水解配方可以通过消除对额外电解质的需求来简化饲料方案，多种维生素和液体丸剂。医疗保健专业人员应该了解低能耗的有效性和可用性，水解配方。
