title: Nutritional support via percutaneous endoscopic gastrostomy in children with cardiac disease experiencing difficulties with feeding.
abstract: Adequate nutrition is crucial to the management of children and infants with cardiac disease. Difficulties with feeding are extremely common, and maintaining an adequate caloric intake, in order to achieve sustained growth, is often not possible without nutritional support. We retrospectively reviewed our experience between 1995 and 1999 in treating 37 children with cardiac disease who underwent percutaneous endoscopic construction of a gastrostomy to augment nutritional needs. We stratified the patients into those with cyanotic heart disease, when saturations of oxygen were less than 95%; those with non-cyanotic heart disease with saturations greater than 95%, and those with minor cardiac disease associated with a systemic disorder. Each group was compared to control children matched for age, sex, and diagnosis. We evaluated, the variation in standard deviation score for body weight over a median period of follow-up of 295 days. Improvements in the standard deviation score for body weight occurred in each of the groups, whereas children in the control groups demonstrated a decrease in standard deviation score for body weight. The median change of the score for body weight was significantly higher in patients managed with gastrostomy compared to controls. We conclude that supplementation using a gastrostomy tube allows the safe delivery of the caloric intake needed to support malnourished children with cardiac disease.
authors.affiliation: Department of Paediatric Cardiology, Royal Liverpool Children's National Health Service Trust, Alder Hey, Liverpool, UK. giogio33@yahoo.com
authors.forename: Giovanna
authors.initials: G
authors.lastname: Ciotti
authors.forename: Ralf
authors.initials: R
authors.lastname: Holzer
authors.forename: Marco
authors.initials: M
authors.lastname: Pozzi
authors.forename: Mark
authors.initials: M
authors.lastname: Dalzell
mesh_terms: D001835:Body Weight / Q000502:physiology; D006328:Cardiac Catheterization; D006348:Cardiac Surgical Procedures; D002669:Child Welfare; D002675:Child, Preschool; D016145:Endoscopy, Digestive System; D004750:Enteral Nutrition; D005260:Female; D005500:Follow-Up Studies; D005767:Gastrointestinal Diseases / Q000503:physiopathology / Q000628:therapy; D005774:Gastrostomy; D006330:Heart Defects, Congenital / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007223:Infant; D007229:Infant Welfare; D007231:Infant, Newborn; D007674:Kidney Diseases / Q000503:physiopathology / Q000628:therapy; D008297:Male; D018529:Nutritional Support; D010349:Patient Compliance; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D006113:United Kingdom