Subject(s)
Infant , Child, Preschool , Child , Child Nutrition Disorders/diet therapy , Infant Nutrition Disorders/diet therapy , Heart Defects, Congenital/diet therapy , Child Nutrition Disorders/etiology , Infant Nutrition Disorders/etiology , Nutritional Support/standards , Heart Defects, Congenital/complicationsABSTRACT
ABSTRACT: Early enteral nutrition (EN) promotes the recovery of critically ill patients, but the initiation time for EN in neonates after cardiac surgery remains unclear.This study aimed to investigate the effect of initiation time of EN after cardiac surgery in neonates with complex congenital heart disease (CHD).Neonates with complex CHD admitted to the CICU from January 2015 to December 2017 were retrospectively analyzed. Patients were divided into the 24-hour Group (initiated at 24âhours after surgery in 2015) (nâ=â32) and 6-hour Group (initiated at 6âhours after surgery in 2016 and 2017) (nâ=â66). Data on the postoperative feeding intolerance, nutrition-related laboratory tests (albumin, prealbumin, retinol binding protein), and clinical outcomes (including duration of mechanical ventilation, CICU stay, and postoperative hospital stay) were collected.The incidence of feeding intolerance was 56.3% in 24-hour Group and 39.4%, respectively (Pâ=â.116). As compared to 24-hour Group, prealbumin and retinol binding protein levels were higher (160.7â±â64.3 vs 135.2â±â28.9âmg/L, Pâ=â.043 for prealbumin; 30.7â±â17.7 vs 23.0â±â14.1âg/L Pâ=â.054 for retinol-binding protein). The duration of CICU stay (9.4â±â4.5 vs 13.3â±â10.4 day, Pâ=â.049) and hospital stay (11.6â±â3.0 vs 15.8â±â10.3 day, Pâ=â.028) were shorter in 6-hour Group.Early EN improves nutritional status and clinical outcomes in neonates with complex CHD undergoing cardiac surgery, without significant feeding intolerance.
Subject(s)
Enteral Nutrition/methods , Heart Defects, Congenital/surgery , Time Factors , Chi-Square Distribution , Coronary Care Units/organization & administration , Coronary Care Units/statistics & numerical data , Enteral Nutrition/standards , Enteral Nutrition/statistics & numerical data , Female , Heart Defects, Congenital/diet therapy , Hospitalization/statistics & numerical data , Humans , Infant, Newborn , Male , Prospective Studies , Retrospective StudiesABSTRACT
BACKGROUND: Infants with complex congenital heart defects (CCHDs) experience alterations in growth that develop following surgical intervention and persist throughout early infancy, but the roles of nutritional intake and method of feeding require further exploration as their roles are not fully explained. OBJECTIVES: The purpose of this study was to characterize trends in growth and nutritional intake during the first 6 months of life in infants with CCHD. METHODS: We conducted a secondary analysis of growth and nutritional data from a pilot study designed to test the feasibility of nurse-guided participatory intervention with parents of infants with CCHD. Measures included demographic data, anthropometric data at birth, hospital discharge, and 6 months of age, nutritional intake at 2 and 6 months of age from parent-completed 24-hour nutrition diaries, and assessment of oral-motor skills between 1 and 2 months of age. Descriptive statistics and correlation and group differences were examined. RESULTS: Data for 28 infants were analyzed. Infants demonstrated a decrease in weight-for-age z score (WAZ) and length-for-age z score (LAZ) from birth to hospital discharge and an increase in WAZ and LAZ by 6 months of age. Many of the infants developed failure to thrive. Across the study period, one third of the infants were receiving enteral nutrition. Infants who were orally fed had better growth WAZ and LAZ at 6 months of age when compared to infants who were enterally fed. DISCUSSION: Infants with CCHD exhibit growth faltering throughout early infancy. Reliance on enteral nutrition did not improve growth outcomes in these infants. Findings suggest nutritional intake may not be enough to meet the nutrient requirements to stimulate catch-up growth.
Subject(s)
Growth and Development , Heart Defects, Congenital/diet therapy , Nutritional Status/physiology , Time Factors , Female , Heart Defects, Congenital/physiopathology , Humans , Infant , Infant Nutritional Physiological Phenomena , Infant, Newborn , Longitudinal Studies , Male , Pilot ProjectsABSTRACT
BACKGROUND: Children with severe congenital heart disease (CHD) need considerable nutritional support to reach normal growth. The actual intake of macro- and micronutrients in outpatient CHD infants over a 6-month period in infancy is not described in the literature. The present study aimed to prospectively investigate the distribution between macro- and micronutrient intake, meal frequency and growth in children with CHD. METHODS: At 6, 9 and 12 months of age, a 3-day food diary and anthropometric data were collected in 11 infants with severe CHD and 22 healthy age- and feeding-matched controls. Macro- and micronutrient intake, meal frequency and growth were calculated. RESULTS: Compared to the healthy controls, CHD infants had a statistically significantly higher intake of fat at 9 months of age (4.8 versus 3.6 g kg(-1) day(-1) ), a higher percentage energy (E%) from fat, (40.6% versus 34.5%) and a lower E% from carbohydrates (46.1% versus 39.6%) at 12 months of age, and a lower intake of iron (7.22 versus 9.28 mg day(-1) ) at 6 months of age. Meal frequency was significantly higher at 6 and 9 months of age (P < 0.01). Mean Z-score weight for height, weight for age and body mass index for age were significant lower (P < 0.01) at all time points. CONCLUSIONS: Despite a higher intake of energy from fat and a higher meal frequency, the intake does not meet the needs for growth, and the results may indicate a low intake of micronutrients in CHD infants.
Subject(s)
Child Development/physiology , Energy Intake , Heart Defects, Congenital/diet therapy , Micronutrients/administration & dosage , Body Mass Index , Body Weight , Case-Control Studies , Diet Records , Dietary Carbohydrates/administration & dosage , Dietary Fats/administration & dosage , Female , Humans , Infant , Iron, Dietary/administration & dosage , Male , Meals , Prospective StudiesABSTRACT
BACKGROUND: Infants undergoing cardiac surgery are at risk of a negative protein balance, due to increased proteolysis in response to surgery and the cardiopulmonary bypass circuit, and limited intake. The aim of the study was to quantify the effect on protein kinetics of a short-term high-protein (HP) diet in infants following cardiac surgery. METHODS: In a prospective, double-blinded, randomized trial we compared the effects of a HP (5 g · kg(-1) · d(-1)) versus normal protein (NP, 2 g · kg(-1) · d(-1)) enteral diet on protein kinetics in children <24 months, on day 2 following surgical repair of congenital heart disease. Valine kinetics and fractional albumin synthesis rate (FSRalb) were measured with mass spectrometry using [1-(13)C]valine infusion. The Mann-Whitney U test was used to investigate differences between group medians. Additionally, the Hodges-Lehmann procedure was used to create a confidence interval with a point estimate of median differences between groups. RESULTS: Twenty-eight children (median age 9 months, median weight 7 kg) participated in the study, of whom in only 20 subjects isotopic data could be used for final calculations. Due to underpowering of our study, we could not draw conclusions on the primary outcome parameters. We observed valine synthesis rate of 2.73 (range: 0.94 to 3.36) and 2.26 (1.85 to 2.73) µmol · kg(-1) · min(-1) in the HP and NP diet, respectively. The net valine balance was 0.54 (-0.73 to 1.75) and 0.24 (-0.20 to 0.63) µmol · kg(-1) · min(-1) in the HP and NP group. Between groups, there was no difference in FSRalb. We observed increased oxidation and BUN in the HP diet, compared to the NP diet, as a plausible explanation of the metabolic fate of surplus protein. CONCLUSIONS: It is plausible that the surplus protein in the HP group has caused the increase of valine oxidation and ureagenesis, compared to the NP group. Because too few patients had completed the study, we were unable to draw conclusions on the effect of a HP diet on protein synthesis and balance. We present our results as new hypothesis generating data. TRIAL REGISTRATION: Dutch Trial Register NTR2334.
Subject(s)
Dietary Proteins/administration & dosage , Heart Defects, Congenital/surgery , Postoperative Care/methods , Protein Biosynthesis , Dietary Fats/administration & dosage , Double-Blind Method , Female , Heart Defects, Congenital/diet therapy , Humans , Hydrogen-Ion Concentration , Infant , Insulin/blood , Male , Prospective Studies , Serum Albumin/metabolism , Valine/administration & dosage , Valine/bloodSubject(s)
Heart Defects, Congenital/complications , Heart Defects, Congenital/diet therapy , Nutrition Assessment , Nutritional Status , Child , Child Development/physiology , Child, Preschool , Constipation/diet therapy , Gastroesophageal Reflux/diet therapy , Heart Defects, Congenital/physiopathology , Humans , Infant , Infant Formula/methods , Infant, NewbornABSTRACT
OBJECTIVES: The goal was to investigate the effect of orally administered synbiotics on outcome of infants with cyanotic congenital heart disease (CCHD). METHODS: A prospective, blinded, randomized controlled trial was conducted to evaluate the effect of synbiotics on outcome of infants with CCHD. The infants with CCHD were assigned randomly to 2 groups. Infants in the study group were given synbiotic (Bifidobacterium lactis plus inulin) added to breast milk or mixed feeding until discharge or death. Infants in the placebo group were fed with breast milk or mixed feeding. The outcome measurements were nosocomial sepsis, necrotizing enterocolitis (NEC; Bell stage ≥ 2), length of NICU stay, and death. RESULTS: A total of 100 infants were enrolled in the trial: 50 in each arm. There were 9 cases of culture-proven sepsis (18%) in the placebo group and 2 cases (4%) in the synbiotic group (P = .03). Length of NICU stay did not differ between the groups (26 [14-36] vs 32 days [20-44], P = .07]. There were 5 cases of NEC (10%) in the placebo group and none in the synbiotic group (P = .03). The incidence of death was lower in synbiotic group (5 [10%] of 50 vs 14 [28.0%] of 50, respectively; P = .04). CONCLUSIONS: Synbiotics administered enterally to infants with CCHD might reduce the incidence of nosocomial sepsis, NEC, and death.
Subject(s)
Heart Defects, Congenital/diet therapy , Heart Defects, Congenital/diagnosis , Synbiotics , Adult , Bifidobacterium/drug effects , Cyanosis , Enterocolitis, Necrotizing/drug therapy , Enterocolitis, Necrotizing/microbiology , Enterocolitis, Necrotizing/pathology , Female , Heart Defects, Congenital/epidemiology , Heart Defects, Congenital/pathology , Humans , Infant , Infant, Newborn , Male , Prospective Studies , Sepsis/drug therapy , Sepsis/microbiology , Sepsis/pathology , Single-Blind Method , Treatment OutcomeABSTRACT
OBJECTIVE: The purpose of our study was to evaluate the safety and effectiveness of radiologic percutaneous gastrostomy and gastrojejunostomy for providing nutritional support in children with cardiac disease. MATERIALS AND METHODS: Retrospective chart review of 58 children with cardiac disease who underwent radiologic percutaneous gastrostomy from November 2001 to June 2005 was conducted. Patient data were collected until January 2007. The patients' weights were collected at the time of insertion and 6, 12, 18, and 24 months after insertion, and weight-for-age z-scores were calculated. RESULTS: The mean weight-for-age z-score increased from -2.79 at the time of radiologic percutaneous gastrostomy insertion to -2.33 (p = 0.05) at 6 months after insertion, -1.89 (p = 0.001) at 12 months, -1.65 (p = 0.0002) at 18 months, and -1.40 (p = 0.0004) at 24 months. Repeated measures regression analysis showed a significant increase in weight-for-age z-score over time (p < 0.0001), with an estimated mean increase in weight-for-age z-score of 0.055 per month. No mortality was associated with the insertion or usage of radiologic percutaneous gastrostomy. Major complications included intestinal perforation (3.4%) and aspiration pneumonia (12.1%). CONCLUSION: Radiologic percutaneous gastrostomy is a safe method for providing long-term nutritional support in children with cardiac disease and is effective for improving growth and nutrition in this group of patients.
Subject(s)
Gastrostomy/methods , Heart Defects, Congenital/diet therapy , Jejunostomy/methods , Radiography, Interventional , Child , Child, Preschool , Female , Gastrostomy/adverse effects , Humans , Infant , Infant, Newborn , Jejunostomy/adverse effects , Male , Nutritional Status , Postoperative Complications , Retrospective Studies , Treatment OutcomeABSTRACT
La prevalencia de desnutrición entre los niños ingresados en una unidad de cuidados intensivos pediátricos (UCIP) se sitúa en alrededor del 15-20%, pese a que se sabe que puede aumentarla morbimortalidad. Objetivo: Analizar el soporte nutricional de los niños ingresados en una UCIP. Valorar la adecuación de los aportes recibidos a los requerimientos y los motivos de la falta de cumplimiento. Material y métodos: De los 238 pacientes ingresados durante un periodo de 6 meses, se recogieron los siguientes datos de 40 pacientes que permanecieron ingresados más de48 horas: filiación, antropometría, características del soporte nutricional y desviaciones sobre el plan de tratamiento. Los requerimientos energéticos se estimaron a partir de la ecuación de Schofield. Resultados: La edad media al ingreso fue de 10,5 ± 23,5 meses (rango: 3 días a 10 años). El 64% de los pacientes había sido intervenido de una cardiopatía congénita. La duración media del ingreso en la unidad fue de 22,6 ± 24,5 días (rango: 3-112). Cinco pacientes fallecieron durante el ingreso. Tipo de soporte nutricional:2 niños recibieron nutrición parenteral (NP) exclusiva; 6 NP + nutrición enteral continua (NEC); 16 NEC; 6 NEC + nutrición enteral intermitente(NEI); 3 NEC + alimentación oral; 3 NEI, y 3 otras combinaciones. El grupo tardó como media 2,17 ± 1,06 días en recibir soporte nutricional desde su admisión en la UCIP. El porcentaje de días de estancia durante los cuales los pacientes recibieron los requerimientos estimados varió entre el 16 y el 65%, en función del método de alimentación utilizado. Sólo un pequeño porcentaje (27,5%) de los pacientes recibió un aporte calórico adecuado durante todo el periodo de hospitalización en la unidad. Conclusiones: Sólo el 27,5% de los niños ingresados en la UCIP recibieron durante el ingreso los aportes estimados. La nutrición enteral, sola o en combinación con otros métodos de alimentación, es la forma de soporte nutricional más empleada. Se precisan protocolos adecuados sobre el soporte nutricional en el paciente en las UCIP para conseguir durante su hospitalización un aporte nutricional óptimo (AU)
The prevalence of malnutrition among children admitted to a Pediatric Intensive Care Unit (PICU) is around 15% to 20%, despite the fact that inadequate nutrition can increase morbidity and mortality. We designed this study to evaluate the nutritional support in a PICU and to determine the causes of in adequate nutritional provision over a 6-month period. Material and methods: The medical records of 40 patients (18 girls, 22 boys), randomly selected from the 238 admissions during the study period, were reviewed. The length of the stay was over 48 hours in every case. The following data were recorded: personal data, anthropometric data, type of nutritional support, time since admission to the PICU, adherence to requirements (Schofield equation) and causes of inadequate nutrient supply. Data are presented as the mean and standard deviation or as a percentage, as appropriate. Results: The mean age at admission was 10.5 ± 23.5 months (range: 3 days to 10 years). Sixty-four percent of the patients had been admitted after surgical treatment of a congenital heart defect. The mean length of stay in the PICU: 22.6 ± 24.5 days (range:3 to 112 days). Five patients died during the PICU stay. Type of nutritional support: 2 children received parenteral nutrition (PN) alone;6, PN plus continuous enteral feeding; 16, continuous drip alone; 6,continuous drip plus bolus feedings; 3, continuous drip plus oral feedings; 3, bolus feedings; and 3, other combinations. On average, NS started 2.17 ± 1.06 days after admission. The percentage of days on which the patients received the estimated requirements ranged between 16% and 65%, depending on the type of NS. Delivery of nutrients was below the prescribed load in 10%of cases. Only 27.5% of the patients received an adequate energy load throughout the entire stay. Conclusions: Only a small percentage of children admitted to the PICU received adequate nutritional support. Enteral nutrition, alone or in combination with other feeding methods, constitutes the most widely employed feeding technique in the PICU. It is necessary to implement nutritional support algorithms in the PICU to improve these results (AU)
Subject(s)
Humans , Male , Female , Child , Critical Care/trends , Critical Care , Protein Deficiency/complications , Child Nutrition Disorders/complications , Child Nutrition Disorders/diagnosis , Protein-Energy Malnutrition/diagnosis , Anthropometry/methods , Enteral Nutrition/methods , Heart Defects, Congenital/diet therapy , Parenteral Nutrition/instrumentation , Prospective StudiesABSTRACT
BACKGROUND: Classification and analysis of congenital heart defects (CHD) in etiologic studies is particularly challenging because of diversity of cardiac phenotypes and underlying developmental mechanisms. We describe an approach to classification for risk assessment of CHD based on developmental and epidemiologic considerations, and apply it to data from the National Birth Defect Prevention Study (NBDPS). METHODS: The classification system incorporated the three dimensions of cardiac phenotype, cardiac complexity, and extracardiac anomalies. The system was designed to facilitate the assessment of simple isolated defects and common associations. A team with cardiologic expertise applied the system to a large sample from the NBDPS. RESULTS: Of the 4,703 cases of CHDs in the NBDPS with birth years 1997 through 2002, 63.6% were simple, isolated cases. Specific associations of CHDs represented the majority of the remainder. The mapping strategy generated relatively large samples for most cardiac phenotypes and provided enough detail to isolate important subgroups of CHDs that may differ by etiology or mechanism. CONCLUSIONS: Classification of CHDs that considers cardiac and extracardiac phenotypes is practically feasible, and yields manageable groups of well-characterized phenotypes. Although best suited for large studies, this approach to classification and analysis can be a flexible and powerful tool in many types of etiologic studies of heart defects.
Subject(s)
Heart Defects, Congenital/classification , Heart Defects, Congenital/diet therapy , Heart Defects, Congenital/epidemiology , Heart Defects, Congenital/etiology , Heart Defects, Congenital/pathology , Humans , Phenotype , Retrospective Studies , Risk Assessment , United StatesSubject(s)
Dental Care for Chronically Ill/methods , Dental Caries/prevention & control , Diet Therapy/adverse effects , Diet, Cariogenic , Dietary Carbohydrates/adverse effects , Celiac Disease/diet therapy , Child , Child, Preschool , Chronic Disease , Cystic Fibrosis/diet therapy , Dental Caries/etiology , Energy Intake , Failure to Thrive/diet therapy , Heart Defects, Congenital/diet therapy , Homocystinuria/diet therapy , Humans , Lactose Intolerance/diet therapy , Phenylketonurias/diet therapySubject(s)
Diet Therapy , Cardiovascular Diseases/diet therapy , Nutrition Assessment , Heart Defects, Congenital/diet therapy , Diabetes Mellitus/diet therapy , Hepatic Insufficiency , Hyperlipidemias , Hypertension/diet therapy , Heart Failure/diet therapy , Renal Insufficiency/diet therapy , Obesity/diet therapy , TransplantationABSTRACT
We conducted a retrospective study of neonatal leukocytosis induced by prostaglandin E(1). Among 45 neonates with congenital heart disease, leukocyte counts increased during PGE(1) infusion. We conclude that PGE(1) infusion is a predictable cause of leukocytosis in newborns with congenital heart disease.
Subject(s)
Alprostadil/adverse effects , Leukocytosis/chemically induced , Female , Heart Defects, Congenital/diet therapy , Humans , Infant, Newborn , Leukocyte Count , Retrospective StudiesABSTRACT
Las cardiopatías congénitas condicionan una serie de alteraciones fisiopatológicas que comprometen el estado nutricional de los niños afectos. La malnutrición es mayor cuando la lesión es cianosante y se intensifica cuando además los pacientes presentan insuficiencia cardiaca o hipertensión pulmonar. Por ello, al establecer el diagnóstico debe valorarse el riesgo nutricional, así como los tiempos de corrección quirúrgica para instaurar un soporte nutricional específico e individualizado, realizado por profesionales dedicados específicamente a esto. Es posible que con frecuencia esté indicado el uso de nutrición enteral; en este caso, si hay distrés respiratorio la vía de elección será una gastrostomía endoscópica percutánea, técnica sencilla y segura que evita la utilización de sonda nasogástrica (AU)
Subject(s)
Female , Infant , Male , Humans , Heart Defects, Congenital/physiopathology , Nutrition Rehabilitation , Heart Defects, Congenital/complications , Heart Defects, Congenital/diet therapy , Preoperative Care/methods , Nutritional Status , Infant Nutrition Disorders/etiologyABSTRACT
OBJECTIVE: To determine the oxygen consumption (VO2), resting energy expenditure, and substrate utilization after cardiac surgery in children. DESIGN: Prospective, observational, cross-sectional study with factorial design. SETTING: Pediatric ICU at a university hospital. PATIENTS: Twenty-six consecutive children during the first 3 days after open-heart surgery. INTERVENTIONS: Patients were mechanically ventilated and received routine therapeutic interventions. MEASUREMENTS AND MAIN RESULTS: VO2, resting energy expenditure, and substrate utilization were determined by indirect calorimetry. Cardiac index was calculated using the Fick equation from the measured VO2 and the arterial-mixed venous oxygen content difference, and this cardiac index value was compared with a simultaneous cardiac index value that was measured by thermodilution whenever possible. There were excellent correlation and agreement between cardiac index measurements by Fick equation and thermodilution, indicating accurate VO2 measurements. VO2 was consistent with predicted values in healthy resting children. Resting energy expenditure was consistent with the predicted basal metabolic rate. The mean caloric intake was 19% of the mean energy expenditure. The respiratory quotient was 0.74 +/- 0.05. The substrate utilization showed a shift toward fat oxidation and either gluconeogenesis or impaired carbohydrate utilization. CONCLUSIONS: Cardiovascular surgery in children does not significantly alter resting energy expenditure but influences the substrate utilization. Perioperative hormonal stress responses and therapeutically administered catecholamines may explain the shift toward fat oxidation.
Subject(s)
Cardiac Surgical Procedures , Energy Metabolism , Heart Defects, Congenital/metabolism , Oxygen Consumption , Substrate Cycling , Basal Metabolism , Calorimetry, Indirect , Carbohydrate Metabolism , Cardiac Output , Child , Child, Preschool , Cross-Sectional Studies , Energy Intake , Gluconeogenesis , Heart Defects, Congenital/diet therapy , Heart Defects, Congenital/surgery , Hospitals, University , Humans , Infant , Intensive Care Units, Pediatric , Lipid Metabolism , Nutritional Requirements , Prospective Studies , ThermodilutionABSTRACT
La desnutrición es una complicación frecuente en lactantes con cardiopatía congénita. Para conocer el efecto de una dieta hipercalórica sobre la ganancia ponderal en lactantes cardiópatas desnutridos, se estudiaron retrospectivamente 30 pacientes (con edad promedio de 9 meses y rango de 2 a 21 meses) con cardiopatía congénita, ingresados a un centro de recuperación nutricional (CREDES) por 60 a 90 días. Recibieron fórmula láctea con densidad calórica de 1,29 kcal/cc; la ingesta calórica promedio fue de 220 kcal*kg*d(ñ 19,8) y la ganancia de peso promedio de 2,5 g*kg*d, 90,6% más de lo esperado para la edad. No hubo diferencia significativa en ganancia ponderal al separar a los pacientes con o sin insuficiencia cardíaca, con o sin cianosis, o por grado de desnutrición. Se encontró una significativa mayor ganancia ponderal en los lactantes con edad sobre el promedio del grupo total (9 meses) versus los lactantes bajo el promedio. El grupo de peor evolución tenía cardiopatía más compleja y enfermedades intercurrentes más graves. El aumento de peso en los períodos libres de enfermedad de ambos grupos fue semejante en relación al período total, 328% de lo esperado para la edad en el tercíl de mejor evolución y 127% en el de peor evolución. Se concluye que con dietas de alta densidad calórica se consiguen ingestas que permiten una aceptable recuperación ponderal en lactantes con cardiopatías congénitas
Subject(s)
Infant , Humans , Male , Female , Heart Defects, Congenital/diet therapy , Infant Nutrition Disorders/diet therapy , Administration, Oral , Energy Intake , Follow-Up Studies , Food, Formulated , Heart Defects, Congenital/complications , Heart Defects, Congenital/diagnosis , Infant Nutrition Disorders/diagnosis , Infant Nutrition Disorders/etiology , Nutritional Status , Retrospective StudiesABSTRACT
La evolución, pronóstico y complicaciones de las malformaciones cardíacas congénitas dependen de la severidad de la anomalía anatómica y de las intercurrencias que se produzcan durante su evolución. Es frecuente encontrar, sobre todo en las anomalías severas, compromiso del estado nutricional. El momento quirúrgico óptimo se encuentra supeditado en ocasiones, a lograr un peso adecuado para afrontar la cirugía cardiovascular con el menor riesgo. La nutrición clínica contribuye en este sentido a adelantar el momento para la intervención. El objetivo de este estudio es analizar la situación metabólica y nutricional de los niños con cardiopatías congénita internados en la Unidad I del Hospital de Niños Ricardo Gutiérrez y efectuar las correcciones dietoterápicas necesarias para mejorar su estado nutricional. Se determinó gasto energético basal (GEB) por calorimetría indirecta en 6 niños con cardiopatías congénitas y 6 controles que se encontraban internados por otra patología. El GEB fue de 82 ñ 3 Kcal en las cardiopatías y 85 ñ kcal en los controles. Se demostró una correlación significativa entre el déficit de peso y el GEB que motivó la discusión de las pautas alimentarias adecuadas a estos pacientes sobre la base de las siguientes premisas. Aumentar la densidad energética, disminuir la malabsorción de nutrientes, asegurar balance hídrico, disminuir la carga potencial de solutos y proveer suplementación vitamínica y mineral (AU)
Subject(s)
Humans , Comparative Study , Heart Defects, Congenital/diet therapy , Nutritional Status , Energy MetabolismABSTRACT
La evolución, pronóstico y complicaciones de las malformaciones cardíacas congénitas dependen de la severidad de la anomalía anatómica y de las intercurrencias que se produzcan durante su evolución. Es frecuente encontrar, sobre todo en las anomalías severas, compromiso del estado nutricional. El momento quirúrgico óptimo se encuentra supeditado en ocasiones, a lograr un peso adecuado para afrontar la cirugía cardiovascular con el menor riesgo. La nutrición clínica contribuye en este sentido a adelantar el momento para la intervención. El objetivo de este estudio es analizar la situación metabólica y nutricional de los niños con cardiopatías congénita internados en la Unidad I del Hospital de Niños Ricardo Gutiérrez y efectuar las correcciones dietoterápicas necesarias para mejorar su estado nutricional. Se determinó gasto energético basal (GEB) por calorimetría indirecta en 6 niños con cardiopatías congénitas y 6 controles que se encontraban internados por otra patología. El GEB fue de 82 ñ 3 Kcal en las cardiopatías y 85 ñ kcal en los controles. Se demostró una correlación significativa entre el déficit de peso y el GEB que motivó la discusión de las pautas alimentarias adecuadas a estos pacientes sobre la base de las siguientes premisas. Aumentar la densidad energética, disminuir la malabsorción de nutrientes, asegurar balance hídrico, disminuir la carga potencial de solutos y proveer suplementación vitamínica y mineral