medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2025-047medsovet-8983Research ArticleШКОЛА ПЕДИАТРАPEDIATRICIAN SCHOOLКлинико-метаболические аспекты белково-энергетической недостаточности у пациентов педиатрических отделений интенсивной терапииClinical and metabolic aspects of protein-energy malnutrition in patients in pediatric intensive care unitshttps://orcid.org/0000-0003-3501-9660ЛисицаИ. А.LisitsaI. A.

Лисица Иван Александрович - ассистент кафедры общей медицинской практики.

194100, Санкт-Петербург, ул. Литовская, д. 2

Ivan A. Lisitsa - Assistant at the Department of General Medical Practice.

2, Litovskaya St., St Petersburg, 194100

ivan_lisitsa@mail.ruhttps://orcid.org/0000-0002-8290-8674ГрицинскаяВ. Л.GritsinskayaV. L.

Грицинская Вера Людвиговна - д.м.н., профессор кафедры общей медицинской практики, ведущий научный сотрудник лаборатории медикосоциальных проблем в педиатрии.

194100, Санкт-Петербург, ул. Литовская, д. 2

Vera L. Gritsinskaya - Dr. Sci. (Med.), Professor of the Department of General Medical Practice, Leading Researcher of the Laboratory of Medical and Social Problems in Pediatrics.

2, Litovskaya St., St Petersburg, 194100

tryfive@mail.ruhttps://orcid.org/0000-0002-9532-9698ЗавьяловаА. Н.ZavyalovaA. N.

Завьялова Анна Никитична - д.м.н., профессор кафедры пропедевтики детских болезней с курсом общего ухода за детьми.

194100, Санкт-Петербург, ул. Литовская, д. 2

Anna N. Zavyalova - Dr. Sci. (Med.), Professor Head of the Department of Introduction to Paediatric Diseases with the Course of Baby Carehttps.

2, Litovskaya St., St Petersburg, 194100

anzavjalova@mail.ruhttps://orcid.org/0000-0002-2131-4813АлександровичЮ. С.AleksandrovichYu. S.

Александрович Юрий Станиславович - д.м.н., профессор, заведующий кафедрой анестезиологии, реаниматологии и неотложной педиатрии факультета послевузовского и дополнительного профессионального образования.

194100, Санкт-Петербург, ул. Литовская, д. 2

Yurii S. Aleksandrovich - Dr. Sci. (Med.), Head of the Department of Anesthesiology, Intensive Care and Emergency Pediatrics of the Faculty of Postgraduate and Additional Professional Education.

2, Litovskaya St., St Petersburg, 194100

jalex1963@mail.ruhttps://orcid.org/0000-0002-1749-169XЛисовскийО. В.LisovskiiO. V.

Лисовский Олег Валентинович - к.м.н., доцент, заведующий кафедрой общей медицинской практики.

194100, Санкт-Петербург, ул. Литовская, д. 2

Oleg V. Lisovskii - Cand. Sci. (Med.), Head of the Department of General Medical Practice.

2, Litovskaya St., St Petersburg, 194100

oleg.lisowsky@yandex.ruСанкт-Петербургский государственный педиатрический медицинский университетРоссияSaint Petersburg State Pediatric Medical UniversityRussian Federation20250504202501204213Copyright © Лисица И.А., Грицинская В.Л., Завьялова А.Н., Александрович Ю.С., Лисовский О.В., 20252025Лисица И.А., Грицинская В.Л., Завьялова А.Н., Александрович Ю.С., Лисовский О.В.Lisitsa I.A., Gritsinskaya V.L., Zavyalova A.N., Aleksandrovich Y.S., Lisovskii O.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/8983

Неполноценное количественное и/или компонентное питание детей остается актуальной проблемой во всем мире. Генеральной Ассамблеей ООН сформулированы «Глобальные основы мониторинга в области питания», в результате проведения которых уровень острой нутритивной недостаточности в общей детской популяции должен снизиться до 5% к 2025 г. На основании научных публикаций по электронным базам PubMed, EMBASE, Cochrane Library, eLibrary. ru проведен систематический анализ. Полученные данные показали, что в странах с развитой экономикой белковоэнергетическая недостаточность регистрируется у 2,4–26% пациентов, поступивших в медицинские стационарные учреждения. Нутритивная недостаточность у пациентов педиатрического профиля полиэтиологична и может влиять на исход заболевания. Значительную часть в этиологическую структуру белково-энергетической недостаточности у пациентов вносят критические состояния (травмы, тяжелые инфекционные заболевания и их осложнения, деструктивный панкреатит и т. д.). Понимание патогенеза белково-энергетической недостаточности у пациентов в критическом состоянии позволяет оптимально подойти к организации и оказанию помощи, и в частности нутритивной поддержки. Анализ результатов исследований показал, что при мальнутриции у детей в критических состояниях происходит нарушение всех видов обмена: углеводного, белкового, жирового и витаминного. На фоне гиперметаболизма происходят изменения в гормональном и иммунологическом статусе, сдвиги водно-электролитного баланса. В статье представлена схема патогенеза острой белково-энергетической недостаточности критических состояний, а также проанализированы методы коррекции гомеостаза. Представлен широкий спектр специализированных продуктов для организации как зондового, так и перорального питания у детей, нуждающихся в нутритивной поддержке.

Inadequate quantitative and/or component nutrition of children remains an urgent problem worldwide. The General Assembly of the United Nations formulated the “Global Monitoring Framework for Nutrition”, as a result of which the level of acute nutritional deficiencies in the general child population should be reduced to 5% by 2025. A systematic analysis was conducted on the basis of scientific publications in the electronic databases PubMed, EMBASE, Cochrane Library, eLibrary.ru. The data obtained showed that in developed economies protein-energy deficiency is registered in 2.4–26% of patients admitted to medical inpatient facilities. Nutritional deficiency in pediatric patients is polyetiological and can influence the outcome of the disease. Critical conditions (trauma, severe infectious diseases and their complications, destructive pancreatitis, etc.) contribute a significant part to the etiologic structure of protein-energy deficiency in patients. Understanding the pathogenesis of protein-energy deficiency in patients in critical condition allows to optimally approach the organization and provision of care and, in particular, nutritional support. Analysis of the results of studies has shown that malnutrition in children in critical conditions causes a violation of all types of metabolism: carbohydrate, protein, fat, and vitamin metabolism. On the background of hypermetabolism there are changes in hormonal and immunologic status, shifts in water-electrolyte balance. A wide range of specialized products is presented for organizing both tube and oral nutrition in children who need nutritional support.

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The authors declare that there are no conflicts of interest present.