Nutritional status correction options in children with congenital heart disease

Aim. To justify the need of nutritional status assessment and correction in children with congenital heart disease.

Methods. Clinical examination, somatometric methods (height, weight, head and chest circumference measuring) were used. Anthropometric data were evaluated using the WHO Anthro, WHO AnthroPlus (2009) programm. The following parameters were analyzed: weight/age, weight/height, height/age, body mass index/age.

Results. The review summarizes the existing data on the etiology and pathogenesis of protein-losing enteropathy and methods of its correction. Own observation is described. A girl, born in 1999 from the fifth pregnancy, occurring on the background of toxicosis and threat of abortion, premature second delivery. Birth weight was 1280 g, length 34 cm. Congenital heart disease (double discharge of the right ventricle main vessels, common open atrioventricular canal, defect of interventricular septum, common atrium, the «riding» mitral valve, left ventricle hypoplasia) is diagnosed in maternity hospital. One year after the Fontan surgery was conducted (in August, 2011) hypoproteinemia (total protein content of 44 g/l) was noticed for the first time in the biochemical blood analysis, and swelling appeared on her feet. Intravenous administration of 20% albumin solution was performed numerously, however without positive changes, plasma protein level was low (37 g/l). According to the guidelines, the child was assigned to a specialized diet with «Nutrien standard» 200 ml/dayas an additional source of protein. The child was discharged from the hospital with improvement and recommendations to continue treatment as an outpatient. At follow-up examination in 6 months at our center (November, 2012) the condition was stable, we managed to stop manifestations of exudative enteropathy and to normalize the total protein levels (November, 2012 - 73 g/l), albumin (46 g/l), and blood electrolytes; the girl gained body weight by 2 kg and height increased by 9 cm.

Conclusion. Complex examination and treatment of children with congenital heart disease should include nutritional status assessment and, if necessary, its correction.