Related Experiment Videos
Thiamine deficiency in children with congenital heart disease before and after corrective surgery
R Shamir1, O Dagan, D Abramovitch
1Division of Pediatric Gastroenterology and Nutrition, Schneider Children's Medical Center of Israel. shamirr@netvision.net.il
Insights
Thiamine deficiency (TD) is common in children with congenital heart disease (CHD) before and after surgery. This study found TD prevalence was high, suggesting it
Area of Science:
- Pediatric Cardiology
- Nutritional Science
- Critical Care Medicine
Background:
- Malnutrition is prevalent in children with congenital heart disease (CHD).
- Thiamine deficiency (TD) is associated with malnutrition, critical illness, and diuretic use in adults.
- The relationship between TD and CHD in pediatric patients requires further investigation.
Purpose of the Study:
- To determine the prevalence of thiamine deficiency (TD) in children with congenital heart disease (CHD).
- To investigate the potential association between loop diuretic treatment and TD in pediatric CHD patients.
Main Methods:
- Prospective study of 22 children with CHD (12 VSD, 10 TOF) undergoing surgery.
- Nutritional evaluation, medication review, anthropometric measurements, and laboratory markers collected pre- and post-surgery.
- Thiamine and pyridoxine deficiencies assessed using activated enzyme assays.
Main Results:
- 18% of children had thiamine deficiency (TD) pre-surgery, with 3 of 4 having adequate thiamine intake.
- 13.6% (3/22) of children had TD pre-surgery, with 1/12 with VSD and 3/10 with TOF.
- Post-surgery, 27% (6/22) of children exhibited TD, with 3 from each group (VSD and TOF).
- Anthropometric measurements were lower in VSD patients compared to TOF patients, but not statistically significant.
Conclusions:
- Thiamine deficiency (TD) is common in children with congenital heart disease (CHD) undergoing corrective surgery.
- Neither diuretic use nor malnutrition alone fully explains TD development in this pediatric population.
- Further research is needed to elucidate the underlying mechanisms of TD in pediatric CHD.
Background:
Malnutrition is common in children with congenital heart disease, while thiamine deficiency (TD) is common in malnutrition, in critically ill children, and in adults with congestive heart failure treated with loop diuretics. Our goal was to determine whether children with congenital heart disease had TD and whether treatment with loop diuretics is related to TD in these patients.
Methods:
Twelve children with ventricular septal defect (VSD) treated with furosemide, and 10 children with tetralogy of Fallot (TOF) referred for corrective surgery were consecutively enrolled into a prospective study. Data were collected 24 hours before surgery and 5 days after surgery for nutrition evaluation, medications used, anthropometric measurements, and laboratory markers of malnutrition. Thiamine and pyridoxine deficiencies were evaluated using activated enzyme assays.
Results:
Seven children (32% of patients) did not meet the recommended daily allowance (RDA) for calories and 18% of patients did not meet the RDA for thiamine intake. Anthropometric measurements were low in both groups, more so in those with VSD, although the difference did not reach statistical significance. Overall, 18% (1/12 with VSD and 3/10 with TOF) of children with congenital heart disease had thiamine deficiency before surgery. Three of the four children with TD had adequate intake of thiamine. Six children (27%) had TD 5 days postsurgery (3 children with VSD and 3 children with TOF).
Conclusions:
TD is common in children with congenital heart disease (CHD) referred for corrective surgery both before and after surgery. Our results suggest that neither diuretic treatment nor malnutrition can fully explain the development of TD in these children.