Hemodynamic findings during treatment of protein-calorie malnutrition

Several hemodynamic parameters were sequentially determined at rest in 19 African children recovering from marasmic kwashiorkor. Before treatment, the red cell volume averaged 160 ml, the circulation time: 6.6 sec, the cardiac output: 1.00 liter/min, the stroke volume: 9.7 ml/beat, the systemic vascular resistances: 79 units and the arteriovenous differences in blood oxygen content 5.1 volume %. On the 20th realimentation day, red cell volume averaged 169 ml, the circulation time: 5.8 sec, the cardiac output: 1.38 liter/min, the stroke volume: 11.4 ml/beat, systemic vascular resistances: 62 units and arteriovenous difference: 4.2 volume %. On the 60th realimentation day, red cell volume averaged 208 ml, circulation time: 5.6 sec, cardiac output: 1.53 liter/min, stroke volume: 11.8 ml/beat, systemic vascular resistances: 56 units and arteriovenous differences: 4.1 volume%; both red cell volume and stroke volume were still significantly lower than in the control group. The children recovering from marasmic kwashiorkor showed a rapid transition from a hypocirculatory state into a near normal circulatory state with delayed increase in both red cell volume and stroke volume.