Fluids, Electrolytes & Nutrition: Protein-Energy Malnutrition (PEM)

Protein-Energy Malnutrition (PEM)

Basics

  • Definition: Malnutrition Caused by Deficiency in Dietary Protein or Total Calories
  • Leading Cause of Mortality in Pediatrics < 5 Years Old Worldwide

Marasmus

  • Most Common Form of PEM
  • Cause: Deficiency of All Nutrients, Particularly Total Calories
  • Presentation:
    • Muscle Wasting (Decreased Mid-Upper Arm Circumference/MUAC)
    • Low Total Weight
    • No Edema

Kwashiorkor Mn

  • Cause: Deficiency of Proteins
  • Presentation:
    • Muscle Wasting (Decreased Mid-Upper Arm Circumference/MUAC)
    • Normal Total Weight
    • Edema (Peripheral Pitting Edema & Anasarca)

Mnemonic

Kwashiorkor vs Marasmus

  • Kwashi-O-rkor is Due to Pr-O-tein Deficiency
    • Marasmus from Total Calorie Deficiency
  • K-WASH-iorkor is “Washed” in Extra Fluid (Edema)
    • No Edema in Marasmus