El-Koofy Nehal, Mahmoud Amira M, Fattouh Aya M
Department of Pediatrics, Cairo University, Cairo, Egypt.
Turk J Pediatr. 2017;59(4):442-451. doi: 10.24953/turkjped.2017.04.011.
El-Koofy N, Mahmoud AM, Fattaouh AM. Nutritional rehabilitation for children with congenital heart disease with left to right shunt. Turk J Pediatr 2017; 59: 442-451. Children with congenital heart disease (CHD) are prone to malnutrition. We aimed to assess the nutritional status of infants with CHD and evaluate the role of nutritional counseling. A cohort study included 50 patients with acyanotic CHD causing increased pulmonary blood flow consecutively enrolled from the cardiology clinic in Cairo University Children Hospital. The patients were subjected to clinical evaluation, nutritional assessment with detailed nutritional history, anthropometric measurements and subjective global assessment (SGA) score and complete blood count, serum albumin and total protein assessment. Degree of failure to thrive (FTT) was assessed and nutritional counselling was offered to those patients; followed up for 3 months then re-evaluated. The mean age was (8.6±4.8 months) with male: female ratio 1:1. The overall prevalence of malnutrition was 62%. Fourteen patients had mild FTT and 17 patients had severe FTT [47.1% with mild heart failure (HF) and 47.1% had moderate or severe HF]. All patients with moderate to severe HF had severe FTT and 80% of those with mild HF had severe FTT. Anemia was present in 96% of the patients. Patients with moderate or severe FTT had more severe degree of HF (p < 0.001), more complications (p < 0.001), more frequent hospital admission (p < 0.001) and less optimum breast feeding (p < 0.001). It was found that 76.5% of those with moderate to severe FTT were formula fed (p 0.002) and significantly lower rate of optimum weaning among (p 0.037). There was significant improvement in the anthropometry, the SGA and degree of FTT, level of albumin with decrease in the percent of anemia among the included patients after nutritional rehabilitation. Malnutrition represents serious problem to children with CHD. Nutritional assessment and proper counseling help to improve the nutritional status of those patients.
埃尔 - 库菲N、马哈茂德·A·M、法塔乌赫·A·M。左向右分流型先天性心脏病患儿的营养康复。《土耳其儿科学杂志》2017年；59: 442 - 451。先天性心脏病（CHD）患儿易患营养不良。我们旨在评估CHD婴儿的营养状况并评估营养咨询的作用。一项队列研究纳入了50例因非青紫型CHD导致肺血流量增加的患者，这些患者是从开罗大学儿童医院心脏病科连续招募的。对患者进行了临床评估、通过详细的营养史进行营养评估、人体测量以及主观全面评定（SGA）评分，并进行了全血细胞计数、血清白蛋白和总蛋白评估。评估了生长发育迟缓（FTT）的程度，并为这些患者提供了营养咨询；随访3个月后再次进行评估。平均年龄为（8.6±4.8个月），男女比例为1:1。营养不良的总体患病率为62%。14例患者有轻度FTT，17例患者有重度FTT [47.1%有轻度心力衰竭（HF），47.1%有中度或重度HF]。所有中度至重度HF患者均有重度FTT，80%的轻度HF患者有重度FTT。96%的患者存在贫血。中度或重度FTT患者的HF程度更严重（p < 0.001），并发症更多（p < 0.001），住院更频繁（p < 0.001），最佳母乳喂养情况更少（p < 0.001）。发现76.5%的中度至重度FTT患者采用配方奶喂养（p 0.002），最佳断奶率显著更低（p 0.037）。营养康复后，纳入患者的人体测量、SGA、FTT程度、白蛋白水平均有显著改善，贫血百分比降低。营养不良是CHD患儿面临的严重问题。营养评估和适当的咨询有助于改善这些患者的营养状况。
