JOURNAL Malnutrition and growth failure in cyanotic and acyanotic congenital heart disease with and without pulmonary

hypertension

Perceptor : dr. Manan Affandi, Sp.A dr. Rachmat Gumelar, Sp.A dr. Tina Ramayanthi, Sp.A

Bellinda Nadya Putri 1102007059

length and head circumference. acyanotic with pulmonal hypertension (aP) and acyanotic without pulmonal hypertension (ap) Methods : .Using standard measurements of weight.Abstract Aim : To investigate the effect of several types of congenital heart disease (CHD) on nutrition and growth Patients : Malnutrition and growth failure was investigated in 89 patients with CHD aged 1-45 months and they were according to cardiac diagnosis : cyanotic with pulmonal hypertension (cP). cyanotic without pulmonal hypertension (cp). thin and weak hair) were made by one nurse .Interview with patients’ parents . for physical signs of malnutrition (skin lesions.

Results :There was no significant difference between groups in term of parental education status. duration of breast feeding. and cyanotic patients with pulmonary hypertension are the ones most severely affected . Pulmonary hypertension appears to be the most important factor. sosioeconomic level. and number of siblings Group cP (cyanotic patients with pulmonary hypertension) including to moderate to severe malnutrition Group aP (acyanotic patients with pulmonary hypertension) including to mild or borderline malnutrition Group cp (cyanotic patients without pulmonary hypertension) normal in nutritional state Conclusions: Patients with CHD are prone to malnutrition and growth failure.

maintenance. and specific functions .Background of the Study WHO defines malnutrition as the cellular imbalance between the supply of nutrients and energy and the body’s demand for them to ensure growth.

thin and weak hair) • Measurements of pulmonary artery pressure. head circumference. pulmonary vasculary resistence index. haemoglobin. cP. ap.Patients & Methods • 89 patients with cardiac diagnosis • Patients were assigned to four groups (aP. length. and cp) • Information on sosioeconomic level. education status of the parents. checking their weight. and physical signs of malnutrition (skin lesions. nutrition hystory by interview with patients’ parents • Standardised measurements by one nurse for physical examination. patients’ birth weight. aortic oxygen saturation. albumin and venous pH .

and 40% failure to thrive • Cyanotic patients with pulmonary hypertension were the most severely affected. 56% having moderate to severe malnutrition.Results • Low family sosioeconomic level may have contributed in the causing of this disease • Cyanotic patients without pulmonary hypertension were normal weight for their length or were mildly malnourished (88%). 81% having malnutrition. 56% failure to thrive . 48% were stunted.

Discussion .

What is the importance of nutrition support in patients with congenital heart disease ? .

Incidence of Malnutrition in CHD • Patients with CHD there is an in the frequency and severity of acute / chronic malnutrition • Failure to thrive in infants with CHD • Aggressive nutrition intervention is vital to prevent unsuccessful outcomes associated with malnutrition .

Etiology of Malnutrition • Inadequate caloric intake • Increased energy expenditure due to increased respiratory rate and/or increase metabolic rate • Effects of hypoxia on cellular metabolism .

Energy Expenditure • Decreased rates of weight gain in group with CHD • 49% of study population with inadequate intake due to fatigue and tachypnea • Cyanotic patients with pulmonary hypertension severely affected with malnutrition .

Conclusion In this study shows the additive effects of hypoxia and pulmonary hypertension on nutrition and growth of children with CHD .