Congenital heart disease

Congenital heart disease (CHD) is a defect in the structure of the heart and its large blood vessels which is present at birth.[1] Growth in children with congenital heart disease is often compromised. Cardiac malformations are responsible for undernutrition, which may range from mild undernutrition to severe failure to thrive. Undernutrition may then significantly undermine the outcome of corrective surgical operations and postoperative recovery.

Mechanisms linking CHD to undernutrition may be related either to decreased energy intake and/or to increased energy requirements. Decreased energy intake can involve deficiencies of specific nutrients, or insufficient total caloric intake. Increased respiratory rate accompanying congestive heart failure may be responsible for increased energy requirements.[2]

The goals of nutritional intervention in paediatric CHD patients [3] are to (1) achieve a nutritional balance by providing sufficient energy to stop catabolism of lean body mass, and to provide sufficient protein to meet nitrogen losses; (2) provide additional nutrients to restore deficits as well as for growth, ideally normalising weight for height and promoting linear growth; (3) provide enteral feeds to replace parenteral nutrition as tolerated by the gastrointestinal system; (4) and develop and maintain oral feeding competency to enable voluntary independent feeding.[3]