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Measuring Cardiac Autonomic Nervous System (ANS) Activity in Children
09:45

Measuring Cardiac Autonomic Nervous System (ANS) Activity in Children

Published on: April 29, 2013

Changes in resting energy expenditure in children with congenital heart disease

A Nydegger1, A Walsh, D J Penny

  • 1Department of Gastroenterology and Clinical Nutrition, Royal Children's Hospital, Parkville, Victoria, Australia.

European Journal of Clinical Nutrition
|November 15, 2007
PubMed

Insights

Infants with congenital heart disease (CHD) show increased resting energy expenditure (REE) that normalizes post-surgery. Delayed corrective cardiac surgery impacts infant growth, but catch-up growth occurs by six months.

Area of Science:

  • Pediatric Cardiology
  • Neonatal Metabolism
  • Surgical Outcomes

Background:

  • Congenital heart disease (CHD) significantly impacts infant physiology, including energy expenditure and growth.
  • The timing of cardiac surgery in infants with CHD is a critical factor influencing clinical outcomes.

Purpose of the Study:

  • To investigate the relationship between the timing of corrective cardiac surgery and changes in energy expenditure and growth in infants with CHD.
  • To compare growth and metabolic status in infants undergoing early versus delayed cardiac surgery.

Main Methods:

  • A prospective cohort study involving infants under 1 year with CHD undergoing cardiac surgery.
  • Assessment included anthropometry and indirect calorimetry, with comparisons to healthy controls.
  • Infants were categorized based on surgery timing: within 10 days or after 10 days of life.

Main Results:

  • Infants undergoing corrective surgery after 10 days showed significant deficits in weight and height z-scores compared to those receiving early surgery.
  • Resting energy expenditure (REE) was elevated in infants with CHD before surgery but normalized within one week post-operation.
  • Standard predictive equations for REE were found to be inaccurate for this patient group.

Conclusions:

  • Elevated REE in infants with CHD normalizes rapidly within a week after corrective cardiac surgery.
  • Delayed corrective surgery (after 10 days) is associated with greater pre-operative growth deficits compared to early surgery.
  • Despite initial growth deficits, weight and height normalized by six months post-surgery in both early and delayed surgery groups.
Abstract

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