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Congenital heart nutrition

Jennifer Newcombe, Eileen Fry-Bowers
Neonates with critical congenital heart disease (CCHD) are vulnerable to malnutrition during the post-operative period due to hypermetabolism and hypercatabolism. To improve nutritional outcomes during hospitalization, a nurse led post-operative enteral feeding protocol was implemented at a large U.S. children's hospital. During an eight-month implementation period, twenty-one neonates met protocol inclusion criteria. Days for neonates to achieve goal caloric feedings (120kcal/kg/day) were decreased. A one-way repeated measures analysis of variance showed serum albumin levels and serial anthropometric measurements improved significantly throughout hospitalization (p<0...
January 4, 2017: Journal of Pediatric Nursing
David N Schidlow, Kathy J Jenkins, Kimberlee Gauvreau, Ulisses A Croti, Do Thi Cam Giang, Rama K Konda, William M Novick, Nestor F Sandoval, Aldo Castañeda
BACKGROUND: Little has been published regarding surgery for transposition of the great arteries (TGA) in the developing world. OBJECTIVES: This study sought to identify patient characteristics, surgical interventions, institutional characteristics, risk factors for mortality, and outcomes among patients undergoing surgery for TGA in this setting. METHODS: Developing world congenital heart surgical programs submitted de-identified data to a novel international collaborative database as part of a quality improvement project...
January 3, 2017: Journal of the American College of Cardiology
Sonia Stefanovic, Stéphane Zaffran
Substantial experimental and epidemiological data have highlighted the interplay between nutritional and genetic factors in the development of congenital heart defects. Retinoic acid (RA), a derivative of vitamin A, plays a key role during vertebrate development including the formation of the heart. Retinoids bind to RA and retinoid X receptors (RARs and RXRs) which then regulate tissue-specific genes. Here, we will focus on the roles of RA signaling and receptors in gene regulation during cardiogenesis, and the consequence of deregulated retinoid signaling on heart formation and congenital heart defects...
December 19, 2016: Mechanisms of Development
Bartosz Kulczyński, Anna Gramza-Michałowska
Cardiovascular diseases are the leading cause of death worldwide. Literature data indicate that, due to these diseases, approximately 17.5 million people died in 2012. Types of cardiovascular disease include ischemic heart disease, cerebrovascular disease, peripheral vascular disease, congenital heart disease, rheumatic heart disease, cardiomyopathy and arrhythmia. Proper nutrition is an important factor in reducing the risk of cardiovascular events. An interesting element of our diets is spices. For thousands of years, they have been used in the treatment of many diseases: bacterial infections, coughs, colds, and liver diseases...
November 14, 2016: Postȩpy Higieny i Medycyny Doświadczalnej
Manoj Kumar Sahu, Anuradha Singal, Ramesh Menon, Sarvesh Pal Singh, Alka Mohan, Mala Manral, Divya Singh, V Devagouru, Sachin Talwar, Shiv Kumar Choudhary
BACKGROUND AND OBJECTIVES: Adequate nutritional supplementation in infants with cardiac malformations after surgical repair is a challenge. Critically ill infants in the early postoperative period are in a catabolic stress. The mismatch between estimated energy requirement (EER) and the intake in the postoperative period is multifactorial, predisposing them to complications such as immune deficiency, more infection, and growth failure. This study aimed to assess the feasibility and efficacy of enriched breast milk feed on postoperative recovery and growth of infants after open heart surgery...
October 2016: Annals of Cardiac Anaesthesia
Michelle M Steltzer, Karen Sussman-Karten, Hillary Bishop Kuzdeba, Sandra Mott, Jean Anne Connor
INTRODUCTION: To our knowledge, successful breastfeeding in the population with single ventricle congenital heart disease has not been reported in the literature, particularly during the interstage period. METHOD: A retrospective case study including inpatient nutrition and a complete history of daily logs with the home surveillance monitoring program was performed. RESULTS: Successful full breastfeeding (exceeding prescribed weight growth goals) after Stage I surgery was achieved during the interstage period...
November 2016: Journal of Pediatric Health Care
Shaad Abqari, Akash Gupta, Tabassum Shahab, M U Rabbani, S Manazir Ali, Uzma Firdaus
INTRODUCTION: Congenital heart defects (CHDs) are an important cause of mortality and morbidity in children representing a major global health burden. It is thus important to determine their prevalence and spectrum and identify risk factors associated with the development of heart defects. MATERIALS AND METHODS: A case-control study was carried out in the Department of Pediatrics and Center of Cardiology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India, from February 2014 to August 2015...
September 2016: Annals of Pediatric Cardiology
Alejandro A Floh, Julie Slicker, Steven M Schwartz
OBJECTIVES: The objectives of this review are to discuss the challenges of delivering adequate nutrition to children with congenital heart disease, including pre- and postoperative factors and the role of enteral and parenteral nutrition, as well as the evidence supporting current practices. DATA SOURCE: MEDLINE and PubMed. CONCLUSION: Providing adequate nutritional support is paramount for critically ill infants with congenital heart disease, a population at particular risk for malnutrition...
August 2016: Pediatric Critical Care Medicine
Jina Kim, Zhifei Sun, Brian R Englum, Alexander C Allori, Obinna O Adibe, Henry E Rice, Elisabeth T Tracy
PURPOSE: Concerns have been raised about the use of laparoscopic surgery (LS) in infants with congenital heart disease (CHD) due to their unique physiology. Prior studies on the safety and effectiveness of laparoscopy in children with CHD are limited in scope and cohort size. MATERIALS AND METHODS: We identified children <1 year of age with CHD who underwent abdominal surgery in the 2012-2013 American College of Surgeons National Surgical Quality Improvement Project Pediatric database...
October 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Pankajkumar A Kasar, Raghavan Nair Suresh Kumar, Vellappillil Raman Kutty
OBJECTIVES: To assess the impact of congenital heart surgery on anthropometric scores of growth in economically disadvantaged children. METHODS: A cohort of 100 economically disadvantaged children was followed up after cardiac surgery for their nutritional recovery. Weight, height and body mass index for age were measured just before surgery and at a median period of 48.1 months (range 9-59.9 months) after surgery. Z scores of the age-adjusted variables were computed and McNemar OR was calculated for odds of improvement...
2011: Heart Asia
Dicky Fakhri, Samsuridjal Djauzi, Tri Wahyu Murni, Jusuf Rachmat, Alida Roswita Harahap, Sri Endah Rahayuningsih, Muchtaruddin Mansyur, Anwar Santoso
BACKGROUND: Sepsis is one of the complications following open heart surgery. Toll-like receptor 2 and toll-interacting protein polymorphism influence the immune response after open heart surgery. This study aimed to assess the genetic distribution of toll-like receptor 2 N199N and toll-interacting protein rs5743867 polymorphism in the development of postoperative sepsis. METHODS: A prospective cohort study was conducted in 108 children <1-year old who underwent open heart surgery with a Basic Aristotle score ≥6...
May 2016: Asian Cardiovascular & Thoracic Annals
Pirouz Shamszad, Joseph W Rossano, Bradley S Marino, Adam W Lowry, Jarrod D Knudson
OBJECTIVE: To assess how obesity or diabetes mellitus impacts outcomes in patients undergoing cardiac surgery in pediatric hospitals. DESIGN: A multi-institutional, matched case-control study of the Pediatric Health Information System database was performed. SETTING: Tertiary children's hospitals in the United States. PATIENTS: All cardiac surgical cases in patients with obesity or diabetes mellitus between 2004 and 2012 were included...
September 2016: Congenital Heart Disease
Heidi E Karpen
Both protein and energy malnutrition are common in neonates and infants with congenital heart disease (CHD). Neonates with CHD are at increased risk of developing necrotizing enterocolitis (NEC), particularly the preterm population. Mortality in patients with CHD and NEC is higher than for either disease process alone. Standardized feeding protocols may affect both incidence of NEC and growth failure in infants with CHD. The roles of human milk and probiotics have not yet been explored in this patient population...
March 2016: Clinics in Perinatology
Amy Donnellan, Lindsey Justice
Hypoplastic left heart syndrome is a severe form of congenital heart disease that results in single-ventricle physiology. Although surgical palliation in infants with this syndrome is widely agreed on in practice, variation occurs in both surgical and medical management. Perinatal factors that affect preoperative management include the subtype of the syndrome and the patient's birth weight, gestational age, and genetic abnormalities. The general aspects of perioperative stabilization and management are monitoring, use of vasoactive infusions, ventilatory support, and nutrition...
February 2016: Critical Care Nurse
A Blasquez, H Clouzeau, M Fayon, J-B Mouton, J-B Thambo, R Enaud, T Lamireau
BACKGROUND/OBJECTIVES: The objective of this disease was to determine the prevalence of malnutrition in children with congenital heart disease (CHD). SUBJECTS/METHODS: A total of 125 children with CHD, under 6 months of age, were divided into four groups: no pulmonary hypertension (PH) or cyanosis (group 1, n=47), isolated cyanosis (group 2, n=52), isolated PH (group 3, n=16), and PH and cyanosis (group 4, n=10). Six children died at 6 months (n=4), 12 months (n=1) and 19 months (n=1)...
April 2016: European Journal of Clinical Nutrition
Ijeoma Arodiwe, Josephat Chinawa, Fortune Ujunwa, Dabere Adiele, Mildred Ukoha, Egbuna Obidike
BACKGROUND AND OBJECTIVES: Children with congenital heart disease (CHD) are prone to malnutrition. This can have a significant effect on the outcome of surgery. Our objective was to determine the burden and determinant of malnutrition in children with several types of congenital heart disease (CHD). METHODS: This is a descriptive cross sectional study of children attending the outpatient clinic of UNTH, Ituku - Ozalla, Enugu State, over a six year period from March 2007 to April 2014...
September 2015: Pakistan Journal of Medical Sciences Quarterly
Sarah Wisecup, Shannan Eades, Yuliya Turiy
OBJECTIVES: With the apparent increase in venous thromboembolism noted in the pediatric population, it is important to define which children are at risk for clots and to determine optimal preventative therapy. The purpose of this study was to determine the risk factors for venous thromboembolism in pediatric patients with central venous line placement. METHODS: This was an observational, retrospective, case-control study. Control subjects were patients aged 0 to 18 years who had a central venous line placed...
September 2015: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
Chinwendu Onwubiko, Sigrid Bairdain, Andrew J Murphy, Maireade E McSweeney, Julia Perkins, Rahul H Rathod, Christopher Baird, C Jason Smithers
INTRODUCTION: Gastrojejunostomy (GJ) tubes are an option for durable enteral access for critically ill infants with congenital cardiac disease who struggle with obtaining adequate nutrition. MATERIALS AND METHODS: Infants weighing less than 10 kg with cardiac disease who received placement of a laparoscopic GJ tube from November 2011 to January 2015 were reviewed. The operative technique used an umbilical port for the camera and a single stab incision for the gastric access site...
December 2015: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Agnieszka Szlagatys-Sidorkiewicz, Anna Borkowska, Katarzyna Popińska, Ewa Toporowska-Kowalska, Urszula Grzybowska-Chlebowczyk, Anna Wernicka, Ewa Hapyn, Marta Sibilska, Beata Gębora-Kowalska, Sabina Więcek, Paweł Zagożdżon, Jarosław Kierkuś
PURPOSE: The aim of this study was to analyze whether the insertion of Percutaneous Endoscopic Gastrostomy (PEG) during infancy is related to higher morbidity. Moreover, we analyzed the structure of indications to PEG placement in various age groups of pediatric patients. MATERIAL/METHODS: The study involved medical data of children after PEG insertion from six Polish endoscopic centers: infants (<12 months of age), toddlers (12-36 months), and preadolescents (>36 months)...
March 2016: Advances in Medical Sciences
Nancy A Pike, Carol A Okuhara, Joy Toyama, Barbara P Gross, Winfield J Wells, Vaughn A Starnes
BACKGROUND: Persistent pleural effusions after the Fontan procedure contribute to prolonged hospitalization and increased costs. We report our experience using a modified Wisconsin Fontan protocol to reduce chest tube drainage and hospital length of stay (LOS). METHODS: Single institutional retrospective chart review of 120 consecutive patients (60 before and 60 after initiation of our protocol) undergoing an extracardiac Fontan procedure from January 2004 to February 2007...
September 2015: Journal of Thoracic and Cardiovascular Surgery
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