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Assessment of intestinal and cardiorespiratory function in children with congenital heart disease on high-caloric
Insights
Congenital heart disease in infants often causes failure to thrive due to low caloric intake. High-caloric nasogastric tube feeding effectively supports weight gain in these infants.
Area of Science:
- Pediatrics
- Neonatology
- Cardiology
Background:
- Infants with congenital heart disease (CHD) frequently experience failure to thrive (FTT).
- Intestinal function and caloric intake are critical factors in FTT for these infants.
Purpose of the Study:
- To investigate the causes of FTT in infants with CHD.
- To evaluate the efficacy of high-caloric nasogastric tube feeding for weight gain in infants with CHD.
Main Methods:
- Assessed intestinal function, including absorptive abnormalities and gastric emptying.
- Monitored weight gain and cardiorespiratory rates during different feeding regimens.
- Compared voluntary oral intake with nasogastric tube feeding of a high-caloric diet.
Main Results:
- Minor absorptive abnormalities and delayed gastric emptying were observed.
- Low caloric intake (88.3 kcal/kg/day) was identified as the primary cause of FTT.
- Nasogastric tube feeding (169 kcal/kg/day) resulted in significant weight gain.
- Transient increases in respiratory and heart rates were noted post-feeding.
Conclusions:
- Low caloric intake is a major contributor to FTT in infants with CHD.
- High-caloric nasogastric tube feeding is an effective and metabolically inexpensive method for promoting weight gain.
- This feeding strategy supports nutritional needs and improves growth outcomes in infants with CHD.
Abstract:
Fourteen infants with congenital heart disease were investigated for failure to thrive. Assessment of intestinal function revealed minor absorptive abnormalities (mild steatorrhea in three patients, bile salt loss in four patients), delayed gastric emptying, and abnormal triglyceride loading tests. Low caloric intake (88.3 +/- 19.3 kcal/kg/day) seemed the main reason for failure to gain weight. Weight accession and cardiorespiratory rates were monitored daily during voluntary intake, a high-caloric diet by mouth, and nasogastric tube feeding. Providing 169 +/- 29 kcal/kg/day by tube resulted in weight gain with mild and transient elevation of respiratory rate at the end of the meal and increased heart rate 90 min after the meal. This regimen is a metabolically inexpensive and efficient method of supporting weight gain in children with congenital heart disease.