Doğuştan kalp hastalığı olan çocuklarda beslenme durumunun değerlendirilmesi
Thesis Type: Expertise In Medicine
Institution Of The Thesis: Ankara University, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Turkey
Approval Date: 2020
Thesis Language: Turkish
Student: SEDEF BAYAR
Supervisor: AYDAN KANSU TANCA
Open Archive Collection: AVESIS Open Access Collection
Abstract:Congenital heart disease (CHD) is the commonest birth defect worldwide, affecting millions of newborns every year. CHD is typically defined as a structural abnormality of the heart and/or great vessels that is present at birth. Children with congenital heart disease are at increased risk of malnutrition. In this study, it was aimed to evaluate the nutritional status, determine the frequency of malnutrition, determine the factors affecting the development of malnutrition, reveal nutritional supplements and determine its relationship with prognosis. Methods: This is a retrospective observational study of infants and young children with CHD aged 0-2 years admitted to hospital for cardiac catheterization. A total of 100 patients who were admitted to the Pediatric Cardiology Service at University of Ankara School of Medicine between January 2014 and December 2017 were included in the study. Anthropometry, growth history, cardiac classification, cardiac diagnosis and nutrition support data were collected from the hospital medical records for each participants. All patients were followed-up for 24 months. Results: 44 (44%) patients were female and 56 (56%) patients were male, male/female ratio was found 1.27. Average age at diagnosis was 3,22 ± 4,77 months. The type of cardiac malformation was evaluated; ventricular septal defect in 26 patients (26%), patent ductus arteriosus in 23 (23%), pulmonary stenosis in 10 (10%), coarctation of the aorta in 8 (8%), aortic stenosis in 7 (7%), atrial septal defect in 6 (6%), tetralogy of Fallot in 4 (4%), pulmonary atresia in 2 (2%), pulmonary stenosis and atrial septal defect in 2 (2%), coarctation of the aorta and ventricular septal defect in 2 (2%) and other in 10 (10%). Ventricular septal defect was the most common defect (29,5%) in acyanotic group while tetralogy of Fallot was the most common defect (33,3%) in cyanotic group. On admission, malnutrition prevalence was 36%. The frequency of acute and chronic malnutrition were as 19% and 15%. In addition, moderate to severe malnutrition was observed in 19% of patients with CHD. Malnutrition was more frequent among patient with pulmonary hypertension and/or uncompensated congestive heart failure. Follow-up analyses showed increased z scores of weight for height (−0,37 ± 1,37 versus 0,13 ± 1,24, P < 0,05), height for age (−0,28 ± 1,18 versus −0,05 ± 1,19, P < 0,05) and weight for age (-0,41 ± 1,13 versus -0,16 ± 1,21, P < 0,05). 35 patients received enteral nutritional support before and after cardiac surgery. Conclusion: Malnutrition remains a problem among children with congenital heart disease, especially in infants with either heart failure and/or pulmonary hypertension. Nutritional status should be closely monitored and appropriate nutritional supportive treatments should be started early to ensure normal growth and increase chances of healthy living. Key words: Congenital heart disease, malnutrition, nutritional support