Argent Andrew C, Balachandran Rakhi, Vaidyanathan Balu, Khan Amina, Kumar R Krishna
1School of Child and Adolescent Health,University of Cape Town,Cape Town,South Africa.
3Department of Cardiac Anesthesiology,Pediatric Cardiac Intensive Care, Amrita Vishwa Vidyapeetham,Cochin,Kerala,India.
Cardiol Young. 2017 Dec;27(S6):S22-S30. doi: 10.1017/S104795111700258X.
Poor growth with underweight for age, decreased length/height for age, and underweight-for-height are all relatively common in children with CHD. The underlying causes of this failure to thrive may be multifactorial, including innate growth potential, severity of cardiac disease, increased energy requirements, decreased nutritional intake, malabsorption, and poor utilisation of absorbed nutrition. These factors are particularly common and severe in low- and middle-income countries. Although nutrition should be carefully assessed in all patients, failure of growth is not a contraindication to surgical repair, and patients should receive surgical repair where indicated as soon as possible. Close attention should be paid to nutritional support - primarily enteral feeding, with particular use of breast milk in infancy - in the perioperative period and in the paediatric ICU. This nutritional support requires specific attention and allocation of resources, including appropriately skilled personnel. Thereafter, it is essential to monitor growth and development and to identify causes for failure to catch-up or grow appropriately.
先天性心脏病患儿生长发育不良、年龄别体重偏低、年龄别身长/身高降低以及身高别体重偏低的情况都较为常见。这种发育迟缓的潜在原因可能是多方面的，包括先天生长潜力、心脏病严重程度、能量需求增加、营养摄入减少、吸收不良以及对吸收营养的利用不佳。这些因素在低收入和中等收入国家尤为常见且严重。尽管所有患者都应仔细评估营养状况，但生长发育不良并非手术修复的禁忌证，患者应在有指征时尽快接受手术修复。围手术期和儿科重症监护病房应密切关注营养支持——主要是肠内喂养，婴儿期尤其应使用母乳。这种营养支持需要特别关注并分配资源，包括配备适当技术的人员。此后，监测生长发育并找出未能追赶或生长不适当的原因至关重要。
