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Addressing Nutrition and Growth in Children with Congenital Heart Disease

Chapter

Abstract

Adequate nutrition is required for infants and children to grow and develop normally. Children with congenital heart disease commonly experience growth failure early in life with major potential consequences. This is especially true for those children who require surgery during the first several weeks of life. The etiology of this growth failure poorly understood but often results in both short and long term adverse outcomes. Careful attention to growth monitoring and appropriate intervention when needed can alleviate some growth problems in children with congenital heart disease. This can be accomplished by standardization of monitoring and nutrition practices. Feeding infants with congenital heart disease also poses some risks including a higher risk of necrotizing enterocolitis and risks associated with enteral feeding via nasogastric tube. While there has been considerable improvement in our understanding of feeding problems in congenital heart disease, there is much work to be done to help understand and alleviate this problem.

Keywords

Congenital heart disease Growth failure Nutrition Clinical outcomes Neurodevelopment 

References

  1. 1.
    Hui W, Grover G. Nutritional needs. In: Berkowitz BD, editor. Berkowitz’s pediatrics: a primary care approach. Elk Grove Village: American Academy of Pediatrics; 2008. p. 63–9.Google Scholar
  2. 2.
    Steltzer M, Rudd N, Pick B. Nutrition care for newborns with congenital heart disease. Clin Perinatol. 2005;32(4):1017–30, xi.PubMedCrossRefGoogle Scholar
  3. 3.
    Himes JH, et al. Parent-specific adjustments for evaluation of recumbent length and stature of children. Pediatrics. 1985;75(2):304–13.PubMedGoogle Scholar
  4. 4.
    Mascarenhas MR, Zemel B, Stallings VA. Nutritional assessment in pediatrics. Nutrition. 1998;14(1):105–15.PubMedCrossRefGoogle Scholar
  5. 5.
    Forchielli ML, et al. Children with congenital heart disease: a nutrition challenge. Nutr Rev. 1994;52(10):348–53.PubMedCrossRefGoogle Scholar
  6. 6.
    Gingell RL, Pieroni DR, Hornung MG. Growth problems associated with congenital heart disease in infancy. In: Lebenthal E, editor. Textbook of gastroenterology and nutrition in infancy. New York: Raven; 1981.Google Scholar
  7. 7.
    Greer F, et al. Cardiac disease. In: Kleinman R, editor. Pediatric nutrition handbook. Elk Grove: American Academy of Pediatrics; 2009. p. 981–99.Google Scholar
  8. 8.
    Anderson JB, et al. Lower weight-for-age z score adversely affects hospital length of stay after the bidirectional Glenn procedure in 100 infants with a single ventricle. J Thorac Cardiovasc Surg. 2009;138(2):397–404.e1.PubMedCrossRefGoogle Scholar
  9. 9.
    Anderson JB, et al. Poor post-operative growth in infants with two-ventricle physiology. Cardiol Young. 2011;21(4):421–9.PubMedCrossRefGoogle Scholar
  10. 10.
    Anderson JB, et al. Low weight-for-age z-score and infection risk after the Fontan procedure. Ann Thorac Surg. 2011;91(5):1460–6.PubMedCrossRefGoogle Scholar
  11. 11.
    Barton JS, et al. Energy expenditure in congenital heart disease. Arch Dis Child. 1994;70(1):5–9.PubMedCentralPubMedCrossRefGoogle Scholar
  12. 12.
    Davis D, et al. Feeding difficulties and growth delay in children with hypoplastic left heart syndrome versus d-transposition of the great arteries. Pediatr Cardiol. 2008;29(2):328–33.PubMedCrossRefGoogle Scholar
  13. 13.
    Pillo-Blocka F, et al. Rapid advancement to more concentrated formula in infants after surgery for congenital heart disease reduces duration of hospital stay: a randomized clinical trial. J Pediatr. 2004;145(6):761–6.PubMedCrossRefGoogle Scholar
  14. 14.
    Vogt KN, et al. Somatic growth in children with single ventricle physiology impact of physiologic state. J Am Coll Cardiol. 2007;50(19):1876–83.PubMedCrossRefGoogle Scholar
  15. 15.
    Kelleher DK, et al. Growth and correlates of nutritional status among infants with hypoplastic left heart syndrome (HLHS) after stage 1 Norwood procedure. Nutrition. 2006;22(3):237–44.PubMedCrossRefGoogle Scholar
  16. 16.
    Rogers EJ, et al. Barriers to adequate nutrition in critically ill children. Nutrition. 2003;19(10):865–8.PubMedCrossRefGoogle Scholar
  17. 17.
    Kogon BE, et al. Feeding difficulty in newborns following congenital heart surgery. Congenit Heart Dis. 2007;2(5):332–7.PubMedCrossRefGoogle Scholar
  18. 18.
    Kyle UG, Genton L, Pichard C. Hospital length of stay and nutritional status. Curr Opin Clin Nutr Metab Care. 2005;8(4):397–402.PubMedCrossRefGoogle Scholar
  19. 19.
    Pichard C, et al. Nutritional assessment: lean body mass depletion at hospital admission is associated with an increased length of stay. Am J Clin Nutr. 2004;79(4):613–8.PubMedGoogle Scholar
  20. 20.
    Leite HP, et al. Serum albumin and clinical outcome in pediatric cardiac surgery. Nutrition. 2005;21(5):553–8.PubMedCrossRefGoogle Scholar
  21. 21.
    Leite HP, et al. Nutritional assessment and surgical risk markers in children submitted to cardiac surgery. Sao Paulo Med J. 1995;113(1):706–14.PubMedCrossRefGoogle Scholar
  22. 22.
    Goldberg C. Neurocognitive outcomes for children with functional single ventricle malformations. Pediatr Cardiol. 2007;28(6):443–7.PubMedCrossRefGoogle Scholar
  23. 23.
    Mahle WT, et al. Neurodevelopmental outcome and lifestyle assessment in school-aged and adolescent children with hypoplastic left heart syndrome. Pediatrics. 2000;105(5):1082–9.PubMedCrossRefGoogle Scholar
  24. 24.
    Marino BS, et al. Neurodevelopmental outcomes in children with congenital heart disease: evaluation and management: a scientific statement from the American Heart Association. Circulation. 2012;126(9):1143–72.PubMedCrossRefGoogle Scholar
  25. 25.
    Mahle WT, Wernovsky G. Neurodevelopmental outcomes in hypoplastic left heart syndrome. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2004;7:39–47.PubMedCrossRefGoogle Scholar
  26. 26.
    Wernovsky G, et al. Cognitive development after the Fontan operation. Circulation. 2000;102(8):883–9.PubMedCrossRefGoogle Scholar
  27. 27.
    Hoffman GM, et al. Systemic venous oxygen saturation after the Norwood procedure and childhood neurodevelopmental outcome. J Thorac Cardiovasc Surg. 2005;130(4):1094–100.PubMedCrossRefGoogle Scholar
  28. 28.
    Bellinger DC, et al. Developmental and neurological status of children at 4 years of age after heart surgery with hypothermic circulatory arrest or low-flow cardiopulmonary bypass. Circulation. 1999;100(5):526–32.PubMedCrossRefGoogle Scholar
  29. 29.
    Hovels-Gurich HH, et al. Long-term behavior and quality of life after corrective cardiac surgery in infancy for tetralogy of Fallot or ventricular septal defect. Pediatr Cardiol. 2007;28(5):346–54.PubMedCrossRefGoogle Scholar
  30. 30.
    Grantham-McGregor S. A review of studies of the effect of severe malnutrition on mental development. J Nutr. 1995;125(8 Suppl):2233S–8.PubMedGoogle Scholar
  31. 31.
    Galler JR, Ramsey F, Solimano G. A follow-up study of the effects of early malnutrition on subsequent development. II. Fine motor skills in adolescence. Pediatr Res. 1985;19(6):524–7.PubMedCrossRefGoogle Scholar
  32. 32.
    Grantham-McGregor SM, Walker S, Chang S. Nutritional deficiencies and later behavioural development. Proc Nutr Soc. 2000;59:47–54.PubMedCrossRefGoogle Scholar
  33. 33.
    Schidlow DN, et al. Variation in interstage outpatient care after the Norwood procedure: a report from the Joint Council on Congenital Heart Disease National Quality Improvement Collaborative. Congenit Heart Dis. 2011;6(2):98–107.PubMedCrossRefGoogle Scholar
  34. 34.
    Anderson JB, et al. Variation in growth of infants with a single ventricle. J Pediatr. 2012;161(1):16–21.e1; quiz 21 e2–3.PubMedCrossRefGoogle Scholar
  35. 35.
    Marik PE, Zaloga GP. Early enteral nutrition in acutely ill patients: a systematic review. Crit Care Med. 2001;29(12):2264–70.PubMedCrossRefGoogle Scholar
  36. 36.
    Braudis NJ, et al. Enteral feeding algorithm for infants with hypoplastic left heart syndrome poststage I palliation. Pediatr Crit Care Med. 2009;10(4):460–6.PubMedCrossRefGoogle Scholar
  37. 37.
    Mehta NM, et al. Nutritional practices and their relationship to clinical outcomes in critically ill children–an international multicenter cohort study*. Crit Care Med. 2012;40(7):2204–11.PubMedCentralPubMedCrossRefGoogle Scholar
  38. 38.
    Medoff-Cooper B, Irving SY. Innovative strategies for feeding and nutrition in infants with congenitally malformed hearts. Cardiol Young. 2009;19 Suppl 2:90–5.PubMedCrossRefGoogle Scholar
  39. 39.
    del Castillo SL, et al. Reducing the incidence of necrotizing enterocolitis in neonates with hypoplastic left heart syndrome with the introduction of an enteral feed protocol. Pediatr Crit Care Med. 2010;11(3):373–7.PubMedGoogle Scholar
  40. 40.
    Premji SS, McNeil DA, Scotland J. Regional neonatal oral feeding protocol: changing the ethos of feeding preterm infants. J Perinat Neonatal Nurs. 2004;18(4):371–84.PubMedCrossRefGoogle Scholar
  41. 41.
    Skillman HE, Wischmeyer PE. Nutrition therapy in critically ill infants and children. JPEN J Parenter Enteral Nutr. 2008;32(5):520–34.PubMedCrossRefGoogle Scholar
  42. 42.
    Slicker J, et al. Nutrition algorithms for infants with hypoplastic left heart syndrome; birth through the first interstage period. Congenit Heart Dis. 2013;8:89–102.PubMedCentralPubMedCrossRefGoogle Scholar
  43. 43.
    Connor JA, et al. Clinical outcomes and secondary diagnoses for infants born with hypoplastic left heart syndrome. Pediatrics. 2004;114(2):e160–5.PubMedCrossRefGoogle Scholar
  44. 44.
    Skinner ML, et al. Laryngopharyngeal dysfunction after the Norwood procedure. J Thorac Cardiovasc Surg. 2005;130(5):1293–301.PubMedCrossRefGoogle Scholar
  45. 45.
    Biewer ES, et al. Chylothorax after surgery on congenital heart disease in newborns and infants-risk factors and efficacy of MCT-diet. J Cardiothorac Surg. 2010;5:127.PubMedCentralPubMedCrossRefGoogle Scholar
  46. 46.
    Panthongviriyakul C, Bines JE. Post-operative chylothorax in children: an evidence-based management algorithm. J Paediatr Child Health. 2008;44(12):716–21.PubMedCrossRefGoogle Scholar
  47. 47.
    Pratap U, et al. Octreotide to treat postoperative chylothorax after cardiac operations in children. Ann Thorac Surg. 2001;72(5):1740–2.PubMedCrossRefGoogle Scholar
  48. 48.
    Rosti L, et al. Octreotide in the management of postoperative chylothorax. Pediatr Cardiol. 2005;26(4):440–3.PubMedCrossRefGoogle Scholar
  49. 49.
    Nguyen DM, et al. The management of chylothorax/chylopericardium following pediatric cardiac surgery: a 10-year experience. J Card Surg. 1995;10(4 Pt 1):302–8.PubMedCrossRefGoogle Scholar
  50. 50.
    Roehr CC, et al. Somatostatin or octreotide as treatment options for chylothorax in young children: a systematic review. Intensive Care Med. 2006;32(5):650–7.PubMedCrossRefGoogle Scholar
  51. 51.
    Jeffries HE, et al. Gastrointestinal morbidity after Norwood palliation for hypoplastic left heart syndrome. Ann Thorac Surg. 2006;81(3):982–7.PubMedCrossRefGoogle Scholar
  52. 52.
    Johnstone JC, Leung JS, Friedman JN. Nasogastric tube misadventures. Clin Pediatr (Phila). 2011;50(10):983–6.CrossRefGoogle Scholar

Copyright information

© Springer-Verlag London 2015

Authors and Affiliations

  1. 1.Cincinnati Children’s Hospital Medical Center, The Heart InstituteCincinnatiUSA

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