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Optimizing Nutrition in Pediatric Heart Failure: The Crisis Is Over and Now It's Time to Feed.

Abstract

Pediatric heart failure is a complex disease occurring when cardiac output is unable to meet the metabolic demands of the body. With improved surgical interventions and medical therapies, survival rates have improved, and care has shifted from focusing on survival to optimizing quality of life and health outcomes. Based on current literature, this review addresses the nutrition needs of infants and children in heart failure and describes the pathophysiology and metabolic implications of this disease. The prevalence of wasting in pediatric heart failure has been reported to be as high as 86%, highlighting the importance of nutrition assessment through all stages of treatment to provide appropriate intake of energy, protein, and micronutrients. The etiology of malnutrition in pediatric heart failure is multifactorial and involves hypermetabolism, decreased intake, increased nutrient losses, inefficient utilization of nutrients, and malabsorption. Children in heart failure often present with tachypnea, tachycardia, fatigue, nausea, and vomiting and consequently may not be able to meet their nutrition requirements through oral intake alone. Nutrition support, including enteral nutrition and parenteral nutrition, should be considered an essential part of routine care. The involvement of multiple allied health professionals may be needed to create a feeding therapy plan to support patients and their families. With appropriate nutrition interventions, clinical outcomes and quality of life can be significantly improved.

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  • Authors+Show Affiliations

    ,

    Nutrition Services, Alberta Health Services, Stollery Children's Hospital, Edmonton, Canada.

    ,

    Department of Pediatrics, University of Alberta and Stollery Children's Hospital, Edmonton, Canada.

    ,

    Department of Pediatrics, University of Alberta and Stollery Children's Hospital, Edmonton, Canada. Faculty of Nursing, University of Alberta, Edmonton, Canada.

    Nutrition Services, Alberta Health Services, Stollery Children's Hospital, Edmonton, Canada. Department of Pediatrics, University of Alberta and Stollery Children's Hospital, Edmonton, Canada. Department of Agricultural, Food and Nutritional Sciences, University of Alberta, Edmonton, Canada.

    Source

    MeSH

    Adolescent
    Calcium, Dietary
    Child
    Child, Preschool
    Dietary Proteins
    Enteral Nutrition
    Fatty Acids, Omega-3
    Heart Failure
    Humans
    Infant
    Intensive Care Units, Pediatric
    Magnesium
    Malnutrition
    Micronutrients
    Nutrition Assessment
    Nutritional Requirements
    Nutritional Status
    Parenteral Nutrition
    Pediatrics
    Quality of Life
    Vitamin D
    Wasting Syndrome

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    28659014

    Citation

    Lewis, Kylie D., et al. "Optimizing Nutrition in Pediatric Heart Failure: the Crisis Is Over and Now It's Time to Feed." Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition, vol. 33, no. 3, 2018, pp. 397-403.
    Lewis KD, Conway J, Cunningham C, et al. Optimizing Nutrition in Pediatric Heart Failure: The Crisis Is Over and Now It's Time to Feed. Nutr Clin Pract. 2018;33(3):397-403.
    Lewis, K. D., Conway, J., Cunningham, C., & Larsen, B. M. K. (2018). Optimizing Nutrition in Pediatric Heart Failure: The Crisis Is Over and Now It's Time to Feed. Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition, 33(3), pp. 397-403. doi:10.1177/0884533617712502.
    Lewis KD, et al. Optimizing Nutrition in Pediatric Heart Failure: the Crisis Is Over and Now It's Time to Feed. Nutr Clin Pract. 2018;33(3):397-403. PubMed PMID: 28659014.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Optimizing Nutrition in Pediatric Heart Failure: The Crisis Is Over and Now It's Time to Feed. AU - Lewis,Kylie D, AU - Conway,Jennifer, AU - Cunningham,Chentel, AU - Larsen,Bodil M K, Y1 - 2017/12/14/ PY - 2017/7/1/pubmed PY - 2019/1/8/medline PY - 2017/6/30/entrez KW - enteral nutrition KW - heart diseases KW - heart failure KW - nutrition assessment KW - nutritional status KW - nutritional support KW - pediatrics SP - 397 EP - 403 JF - Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition JO - Nutr Clin Pract VL - 33 IS - 3 N2 - Pediatric heart failure is a complex disease occurring when cardiac output is unable to meet the metabolic demands of the body. With improved surgical interventions and medical therapies, survival rates have improved, and care has shifted from focusing on survival to optimizing quality of life and health outcomes. Based on current literature, this review addresses the nutrition needs of infants and children in heart failure and describes the pathophysiology and metabolic implications of this disease. The prevalence of wasting in pediatric heart failure has been reported to be as high as 86%, highlighting the importance of nutrition assessment through all stages of treatment to provide appropriate intake of energy, protein, and micronutrients. The etiology of malnutrition in pediatric heart failure is multifactorial and involves hypermetabolism, decreased intake, increased nutrient losses, inefficient utilization of nutrients, and malabsorption. Children in heart failure often present with tachypnea, tachycardia, fatigue, nausea, and vomiting and consequently may not be able to meet their nutrition requirements through oral intake alone. Nutrition support, including enteral nutrition and parenteral nutrition, should be considered an essential part of routine care. The involvement of multiple allied health professionals may be needed to create a feeding therapy plan to support patients and their families. With appropriate nutrition interventions, clinical outcomes and quality of life can be significantly improved. SN - 1941-2452 UR - https://www.unboundmedicine.com/medline/citation/28659014/Optimizing_Nutrition_in_Pediatric_Heart_Failure:_The_Crisis_Is_Over_and_Now_It's_Time_to_Feed_ L2 - https://doi.org/10.1177/0884533617712502 DB - PRIME DP - Unbound Medicine ER -