Year 2019, Volume 5 , Issue 3, Pages 109 - 112 2019-09-06

Catch-up Growth With Enteral Nutrition Support in Children With Congenital Heart Disease
Doğumsal Kalp Hastalığı Nedeniyle Büyüme Geriliği Olan Bebeklerde Enteral Beslenme ile Büyüme Takibi

Alev ARSLAN [1]


Objective: Malnutrition has long been recognized as a common systemic consequence of congenital heart defects. Nutritional support with higher-concentration formulas is needed. The aim of this study was to evalute feeding and growth pattern in malnutrition due to congenital heart defect.

Methods: Sixty-one infants (41 asyanotic and 20 cyanotic) with congenital heart disease, who were supported with an enteral nutrition product because of malnutrition and followed in terms of growth development until 24 months of age were evaluated retrospectively. After malnutrition was detected, an energy intake of 140-150 kcal/kg/day was provided by supplemental enteral nutrition product until surgical or invasive interventional correction was applied. Anthropometric measurements, taken at three-month intervals were calculated according to Centres for Disease Control and Prevention data.

Results: According to results at month 24, 17 patients had mild malnutrition, 4 patients had moderate malnutrition , and 1 had severe malnutrition. Malnutrition was detected in 36% of all patients. In the acyanotic group, as soon as congestive heart failure started at the 6th week, the growth has regressed. There was an increase in the curve two months after corrective surgery / catheter intervention. The height curves were parallel and elevated in both groups after month 3 and no statistically significant difference was found between the groups at month 2. Weight curves were found to be significantly lower, especially in complex cyanotic patients with palliative surgery.

Conclusion: Malnutrition prevalence has decreased but continued in both groups despite enteral nutrition support. Especially in cyanotic heart diseases, the continuation of hypermetabolic status and higher caloric support is needed with close monitorization of malnutrition

Amaç: Malnütrisyon, doğumsal kalp hastalıklarında sık saptanan bir sorundur. Bu hasta grubunda daha yüksek kalori içerikli beslenme ürünleri gerekmektedir. Bu çalışmada doğumsal kalp hastalığı olan malnütrisyonlu bebeklerde beslenme ve büyüme paterni değerlendirilmesi amaçlanmıştır.

Yöntem: Yenidoğan döneminde doğumsal kalp hastalığı tanısı alıp malnütrisyon nedeniyle enteral beslenme ürünü kullanılan ve 24 aylık olana kadar düzenli büyüme-gelişme takibi yapılan 61 bebek (41 asiyanotik ve 20 siyanotik) retrospektif olarak incelendi. Malnütrisyon saptandıktan sonra, cerrahi veya invaziv girişimsel düzeltme uygulanana kadar enteral beslenme ürünü takviyesi ile 140-150 kcal/kg/gün’lük enerji alımı sağlanmıştı. Üç aylık aralıklarla alınan antropometrik ölçümler Dünya Sağlık Örgütü verilerine göre hesaplandı.

Bulgular: Tüm hastaların 24. ay sonuçları değerlendirildiğinde 17 hastada hafif derecede malnütrisyon, dört hastada orta derecede malnütrisyon, bir hastada ağır derecede malnütrisyon mevcuttu. Malnütrisyon, tüm hastaların %36’sında saptandı. Asiyanotik grupta özellikle altıncı haftada konjestif kalp yetersizliğinin başlamasıyla birlikte büyüme eğrisinde gerileme olduğu, cerrahiden / kateter girişiminden iki ay sonra eğrisinde artma olduğu saptandı. Boy eğrileri üçüncü aydan sonra her iki grupta paralel ve yükselme yönünde idi. Yirmi dördüncü ay ölçümlerinde ise iki grup arasında boy açısından istatistiksel fark saptanmadı; ancak malnütrisyon takibinde boya göre ağırlık eğrileri özellikle tüm düzeltme olamayan kompleks siyanotik hastalarda anlamlı olarak daha düşük saptandı.

Sonuç: Enteral beslenme desteğine rağmen her iki grupta da malnütrisyon devam etmiştir. Özellikle siyanotik kalp hastalıklarında hipermetabolik durumun devam etmesi daha yüksek kalori ihtiyacı gerektirir ve malnütrisyon yakından takip edilmelidir.

  • Mehta NM, Corkins MR, Lyman B, et al. Defining pediatric malnutrition: A paradigm shift toward etiology-related definitions. J Parenter Enteral Nutr. 2013;37:460-481. doi:10.3389/fendo.2017.00364
  • Argent AC, Balachandran R, Vaidyanathan B, Khan A, Kumar K. Management of undernutrition and failure to thrive in children with congenital heart disease in low-and middle-income countries. Cardiology in the Young. 2017;26:22-30. doi:10.1017/S104795111700258X
  • Nydegger A, Walsh A, Penny DJ, Henning R, Bines JE. Changes in resting energy expenditure in children with congenital heart disease. Eur J Clin Nutr. 2009;63:392-397. doi:10.1038/sj.ejcn.1602956
  • Growth charts. Centers for Disease Control and Prevention. http://www.cdc.gov/nccdphp/dnpa/growthcharts/resources/growthchart.pdf. Accessed July 24, 2019.
  • Waterlow JC. Classification and definition of protein-calorie malnutrition. Br Med J. 1972;3:566-569. doi:10.1136/bmj.3.5826.566
  • Mehta NM, Compher C, A.S.P.E.N. Board of Directors. A.S.P.E.N. Clinical Guidelines: nutrition support of the critically ill child. J Parenter Enteral Nutr. 2009;33(3):260-276. doi:10.1177/0148607109333114.
  • Kreymann KG, Berger MM, Deutz NE, et al. ESPEN Guidelines on Enteral Nutrition: Intensive care. Clin Nutr. 2006;25(2):210-223.
  • Carmona F, Hatanaka LS, Barbieri MA, et al. Catch-up growth in children after repair of Tetralogy of Fallot. Cardiol Youn. 2012;22(5):507-513. doi:10.1017/S1047951111002009.
  • Radman M, Mack R, Barnoya J. The effect of preoperative nutritional status on postoperative outcomes in children undergoing surgery for congenital heart defects in San Francisco (UCSF) and Guatemala City (UNICAR). J Thorac Cardiovasc Surg. 2014;147(1):442-450. doi:10.1016/j.jtcvs.2013.03.023
  • Eskedal LT, Hagemo PS, Seem E. Impaired weight gain predicts risk of late death after surgery for congenital heart defects. Arch Dis Child. 2008;93(6):495-501. doi:10.1136/adc.2007.126219.
  • Tokel K, Azak E, Ayabakan C, et al. Somatic growth after corrective surgery for congenital heart disease. Turk J Pediatr. 2010;52(1):58-67.
  • Ackerman IL, Karn CA, Denne SC, Ensing GJ, Leitch CA. Total but not resting energy expenditure is increased in infants with ventricular septal defects. Pediatrics. 1998;102(5):1172-1177.
  • Wells JC, Davies PS. Estimation of the energy cost of physical activity in infancy. Arch Dis Child. 1998;78(2):131-136. doi:10.1136/adc.78.2.13.
  • Varan B, Tokel K, Yilmaz G. Malnutrition and growth failure in cyanotic and acyanotic congenital heart disease with and without pulmonary hypertension. Arch Dis Child. 1999;81(1):49-52. doi:10.1136/adc.81.1.49.
Primary Language en
Subjects Medicine
Published Date Eylül 2019
Journal Section Original Article | Clinical Medical Sciences
Authors

Orcid: 0000-0003-4444-0027
Author: Alev ARSLAN
Institution: Baskent University, Faculty of Medicine, Department of Pediatrics, Division of Pediatric Cardiology, Adana, Turkey
Country: Turkey


Dates

Application Date : July 23, 2019
Acceptance Date : September 2, 2019
Publication Date : September 6, 2019

Bibtex @research article { kusbed595676, journal = {Kocaeli Üniversitesi Sağlık Bilimleri Dergisi}, issn = {}, eissn = {2149-8571}, address = {yy.kosbildergi@gmail.com}, publisher = {Kocaeli University}, year = {2019}, volume = {5}, pages = {109 - 112}, doi = {10.30934/kusbed.595676}, title = {Catch-up Growth With Enteral Nutrition Support in Children With Congenital Heart Disease}, key = {cite}, author = {ARSLAN, Alev} }
APA ARSLAN, A . (2019). Catch-up Growth With Enteral Nutrition Support in Children With Congenital Heart Disease. Kocaeli Üniversitesi Sağlık Bilimleri Dergisi , 5 (3) , 109-112 . DOI: 10.30934/kusbed.595676
MLA ARSLAN, A . "Catch-up Growth With Enteral Nutrition Support in Children With Congenital Heart Disease". Kocaeli Üniversitesi Sağlık Bilimleri Dergisi 5 (2019 ): 109-112 <https://dergipark.org.tr/en/pub/kusbed/issue/48182/595676>
Chicago ARSLAN, A . "Catch-up Growth With Enteral Nutrition Support in Children With Congenital Heart Disease". Kocaeli Üniversitesi Sağlık Bilimleri Dergisi 5 (2019 ): 109-112
RIS TY - JOUR T1 - Catch-up Growth With Enteral Nutrition Support in Children With Congenital Heart Disease AU - Alev ARSLAN Y1 - 2019 PY - 2019 N1 - doi: 10.30934/kusbed.595676 DO - 10.30934/kusbed.595676 T2 - Kocaeli Üniversitesi Sağlık Bilimleri Dergisi JF - Journal JO - JOR SP - 109 EP - 112 VL - 5 IS - 3 SN - -2149-8571 M3 - doi: 10.30934/kusbed.595676 UR - https://doi.org/10.30934/kusbed.595676 Y2 - 2019 ER -
EndNote %0 Kocaeli Üniversitesi Sağlık Bilimleri Dergisi Catch-up Growth With Enteral Nutrition Support in Children With Congenital Heart Disease %A Alev ARSLAN %T Catch-up Growth With Enteral Nutrition Support in Children With Congenital Heart Disease %D 2019 %J Kocaeli Üniversitesi Sağlık Bilimleri Dergisi %P -2149-8571 %V 5 %N 3 %R doi: 10.30934/kusbed.595676 %U 10.30934/kusbed.595676
ISNAD ARSLAN, Alev . "Catch-up Growth With Enteral Nutrition Support in Children With Congenital Heart Disease". Kocaeli Üniversitesi Sağlık Bilimleri Dergisi 5 / 3 (September 2019): 109-112 . https://doi.org/10.30934/kusbed.595676
AMA ARSLAN A . Catch-up Growth With Enteral Nutrition Support in Children With Congenital Heart Disease. Kocaeli Üniversitesi Sağlık Bilimleri Dergisi. 2019; 5(3): 109-112.
Vancouver ARSLAN A . Catch-up Growth With Enteral Nutrition Support in Children With Congenital Heart Disease. Kocaeli Üniversitesi Sağlık Bilimleri Dergisi. 2019; 5(3): 112-109.