Menu ENN Search
Language: English Fran├žais

Reduction of Plumpy nut dosage according to degree of edema

This question was posted the Management of wasting/acute malnutrition forum area and has 0 replies.

» Post a reply

Spencer Rivadeneira Danies

Pediatra

Normal user

21 Sep 2023, 22:45

Hola todos, cordial saludo.

El Lineamiento para el manejo de la desnutrición aguda en Colombia, que hace parte de la Resolución 2350 de 2020; recomienda, en el escenario ambulatorio, la reducción del 5% o el 10% del peso, según el grado de edma (leve/moderado), para el cálculo de la dosis de plumpy nut.

Tal restricción no se indica en el escenario intrahospitalario, para el inicio de la F 75, toda vez que, previendo la posible aparicion del Síndrome de Realimentacion; las primeras 24, post diuresis, se inicia F75 a razón de 4 ml/k, incrementando a 7 ml/k de lentre las 25 y 48 horas (teniendo en cuenta que la Resolución 2465 de 2015, recomendaba en este caso iniciar F75 entre 8 -9 ml/k).

Esto ha generado muchas dudas y discusiones académicas entre médicos generales, pediatra y nutricionistas. incluso, en algunos centros hospitalarios, se restringe también el aporte en el paciente hospitalizado, lo que considero somete al niño a una doble restricción.

Espero atento sus siempre valiosos comentarios.

Muy agradecido

___________________________________________________

This question has been automatically translated:

Hello everyone, cordial greetings.

The Guidelines for the management of acute malnutrition in Colombia, which is part of Resolution 2350 of 2020, recommends, in the outpatient setting, a 5% or 10% weight reduction, depending on the degree of edema (mild/moderate), for the calculation of the plumpy nut dose.

Such a restriction is not indicated in the in-hospital setting, for the initiation of F75, since, anticipating the possible appearance of Refeeding Syndrome; the first 24 hours post-diuresis, F75 is started at a rate of 4 ml/k, increasing to 7 ml/k between 25 and 48 hours (taking into account that Resolution 2465 of 2015, recommended in this case to start F75 between 8 -9 ml/k).

This has generated many doubts and academic discussions among general practitioners, paediatricians and nutritionists. In some hospitals, the intake is also restricted in hospitalised patients, which I believe subjects the child to a double restriction.

I look forward to your always valuable comments.

Thank you very much

If you have any problem posting a response, please contact the moderator at post@en-net.org.

Back to top

» Post a reply