Protein energy malnutrition medical therapy: Difference between revisions
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'''Protein energy malnutrition complicated by mild dehydration''' | '''Protein energy malnutrition complicated by mild dehydration''' | ||
Most patients with PEM and mild to moderate dehydration can be treated | Most patients with PEM and mild to moderate dehydration can be treated with oral or nasogastric administration of fluids. | ||
*The" oral rehydration salts" (ORS) solution is recommended. It is prepared by dissolving one packet of these special salts in 1 litre of clean drinking-water | *The" oral rehydration salts" (ORS) solution is recommended. It is prepared by dissolving one packet of these special salts in 1 litre of clean drinking-water | ||
Revision as of 12:41, 8 August 2017
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Protein energy malnutrition Microchapters |
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Patient Information |
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Differentiating Protein energy malnutrition from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Protein energy malnutrition medical therapy On the Web |
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American Roentgen Ray Society Images of Protein energy malnutrition medical therapy |
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Risk calculators and risk factors for Protein energy malnutrition medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Omodamola Aje B.Sc, M.D. [2]
Overview
In some cases, protein energy malnutrition may be complicated by dehydration and specific infections such as pneumonia and septicemia. In such cases, protein energy malnutrition is a medical emergency and requires prompt treatment with oral rehydration and antibiotics.
Medical therapy
In some cases, protein energy malnutrition may be complicated by dehydration and specific infections, such as pneumonia and septicemia. In such cases, protein energy malnutrition is a is a medical emergency and requires prompt treatment with antibiotics.[1]
Protein energy malnutrition complicated by mild dehydration Most patients with PEM and mild to moderate dehydration can be treated with oral or nasogastric administration of fluids.
- The" oral rehydration salts" (ORS) solution is recommended. It is prepared by dissolving one packet of these special salts in 1 litre of clean drinking-water
Protein energy malnutrition complicated by severe dehydration Patients with severe dehydration and patients who do not respond after oral or nasogastric fluids must be treated by intravenous fluid.
- Compound solution of sodium lactate (Ringer's lactate solution for injection; Hartmann's solution)
Protein energy malnutrition complicated by infections
- 1.1.1.1 Infants 6 months to 1 year
- Preferred regimen (1): Procaine benzyl-penicillin (water-miscible)IM (1-2 ml q1d for 5-10 days)
- Preferred regimen (2): Ampicillin 125 mg at q6h intervals for 5-10 days (maximum, 500 mg per dose)
- Alternative regimen (1): Chloramphenicol 50 mg/kg body weight q24h 6-hour intervals for 5days (maximum, 500 mg per day)
- Alternative regimen (2): Tetracycline 5-50 mg/kg body weight orally q24h at 6-hour intervals for 5 days, or 10-15 mg/kg body weight intravenously q24h at 12hour intervals for 5 days
- Alternative regimen (1): Chloramphenicol 50 mg/kg body weight q24h 6-hour intervals for 5days (maximum, 500 mg per day)
- Preferred regimen (2): Ampicillin 125 mg at q6h intervals for 5-10 days (maximum, 500 mg per dose)
- Preferred regimen (1): Procaine benzyl-penicillin (water-miscible)IM (1-2 ml q1d for 5-10 days)
Treatment of Protein energy malnutrition in the first week
- Quantity: Malnourished patients should be fed 125 ml/kg body weight each day for the first 4 or 5 days. As the child's appetite increases on days 6, 7, and 8,oral feeds are increased in amount to 150mllkg body weight per day, and are given every 4 hours (6 feeds per 24 hours).
- Frequency: For the first 2 days malnourished children should be fed q2h, or q12d
This frequency of feeding reduces the risk of the patient's developing hypothermia and hypoglycemia. Severe vomiting and diarrhea are less likely to occur. When the patient is feeding satisfactorily, feeds should be given q3hfor the next 2 or 3 days, and then q4hly.
- Type of feed:Either fluid milk (cow's, goat's, buffalo's, camel's and canned evaporated milk) or milk powder (skimmed or full-cream powder) can be used to prepare milk feeds.
- Cow milk: About 1 litre of full-strength milk feed is prepared by adding 50 g (10 teaspoons) of sugar to 1000 ml undiluted milk.
- Evaporated milk: 500 ml of evaporated milk is mixed with 500 ml of water and 50 g of sugar added to prepare about 1 litre of full-strength milk.
- Full-cream milk powder: Add 150 g of milk powder - i.e., 30 teaspoons or 30 level scoops (as supplied withthe tin)-and 50 g of sugar to
1000 ml of water to prepare approximately 1 liter of full-strength milk.
- Skimmed milk powder: Mix 75 g (15 teaspoons) of skimmed milk powder with 30 g (35 ml) of vegetable oil(6 teaspoons) and 50 g of sugar (10 teaspoons) to a smooth paste. Gradually add: Mix 50 g 00 teaspoons) of sugar into 1000 ml of yogurt to make approximately 1 litre of full-strength feed.
Mineral and vitamin supplements
- Potassium supplements
- Iron and folic acid
- vitamin A
- Vitamin K
- Vitamin C
- Vitamin D
- B complex
References
- ↑ Spady DW, Payne PR, Picou D, Waterlow JC (1976). "Energy balance during recovery from malnutrition". Am J Clin Nutr. 29 (10): 1073–88. PMID 823814.