Related Experiment Videos
Malabsorption in infants with congenital heart disease under diuretic treatment
Insights
Infants with congenital heart disease on diuretics showed increased total body water (TBW) and extracellular water, but not significant malabsorption. Monitoring TBW is suggested for infants failing to thrive.
Area of Science:
- Pediatrics
- Cardiology
- Gastroenterology
Background:
- Infants with congenital heart disease (CHD) often experience congestive heart failure, requiring diuretic treatment.
- Diuretics can impact fluid balance and nutrient absorption.
- Understanding these effects is crucial for managing failure to thrive in pediatric CHD patients.
Purpose of the Study:
- To investigate the relationship between increased total body water (TBW) and intestinal absorption in infants with CHD receiving diuretics.
- To assess malabsorption as a potential cause of failure to thrive in this population.
Main Methods:
- Studied seven infants with CHD on diuretics and six healthy controls over 3 days.
- Recorded food intake, collected stools, and measured total body water (TBW) and extracellular water.
- Analyzed anthropometric measurements, energy, and fat excretion in stools.
Main Results:
- Infants with CHD had lower anthropometric measurements and increased TBW and extracellular water compared to controls.
- Energy and fat excretion in stools were higher in CHD infants, but not significantly different when expressed as a percentage of intake.
- A positive correlation was found between increased TBW and energy/fat excretion as a percentage of intake; malabsorption did not exceed 8%.
Conclusions:
- Malabsorption is not a significant factor in the failure to thrive of infants with CHD on diuretics.
- A negative correlation exists between excess body water and fat/calorie absorption.
- Monitoring TBW is recommended for CHD infants who fail to gain weight.
Abstract:
Intestinal absorption and its relationship to increased total body water was studied in seven infants with congenital heart disease receiving regular diuretics due to congestive heart failure. All infants and six age-matched healthy controls were studied for a 3-d period during which time all food intake was recorded, stools were collected, and total body water content (TBW) and extracellular water were measured. All the anthropometric measurements were lower in the infants with congenital heart disease compared with healthy controls. Energy and fat excretion in the stools were significantly increased in the group of patients, but when expressed as a percentage of daily caloric intake or as a percentage of the specific intake (e.g. fat excretion/fat intake x 100), no statistical differences were found. TBW as a percentage of body weight was increased in our patients compared with our controls (84.95 +/- 5.82% versus 68.65 +/- 4.60%; p = 0.01) and so was extracellular water as a percentage of predicted (200.0 +/- 18.6% versus 100.9 +/- 7.2%; p = 0.001). A positive correlation was found between energy and fat excretion as a percentage of the intake and TBW as a percentage of predicted; energy and fat malabsorption did not exceed 8% in the patients with the highest body water content (120% of predicted). It is concluded that malabsorption is not a significant factor in failure to thrive of patients with congenital heart disease who are receiving regular diuretics. Based on the significant negative correlation between excess body water and fat and calorie absorption, however, it is suggested to monitor TBW in patients who fail to gain weight.