2 research outputs found

    Non Invasive Cardiac Output Measurement in Low And Very Low Birth Weight: A Method Comparison

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    Background : Cardiac output (CO) measurement in low (LBW) and very low (VLBW) birth weight infants is difficult. Hitherto, sporadical transthoracic echocardiography (TTE) is the only non-invasive measurement method. Electrical velocimetry (EV) has been evaluated as an alternative in normal weight newborns. Objectives: The study was designed to evaluate if EV could even be interchangeable with TTE in LBW and VLBW infants. Methods: In 28 (17 LBW, 11 VLBW) premature newborns, n = 228 simultaneous TTE (transaortic Doppler) and EV measurements (134 LBW, 94 VLBW) of stroke volume (SV) and heart rate (HR) were performed, thereof calculating body weight indexed SV (= SV*) and CO (= CO*) for all patients and the subgroups. Method comparison was performed by Bland-Altman plot, method precision expressed by calculation of the coefficient of variation (CV). Results: Mean CO* in all patients was 256.4 ± 44.8 (TTE) and 265.3 ± 48.8 (EV) ml/kg/min. Bias and precision were clinically acceptable, limits of agreement within the 30% criterion for method interchangeability (Critchley and Critchley, 1999). According to their different anatomic dimensions and pathophysiology, there were significant differences of SV(*), HR and CO* for LBW and VLBW infants as well for inotropic treatment and ventilation mode.Conclusions: Extending recent publications on EV/TTE comparison in newborns, this study suggests that EV is also applicable in LWB/VLBW infants as a safe and easy to handle method for continuous CO monitoring in the NICU and PCICU. <br/

    Nutritional Status in Children with un-operated Congenital Heart Diseases:An Egyptian Center Experience

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    Background: Malnutrition is a common cause of morbidity and mortality in children with congenital heart disease (CHD).This study aimed to identify prevalence and predictors of malnutrition in Egyptian children with symptomatic CHD.Methods: This case-control study included 100 children with symptomatic CHD (76 acyanotic and 24 cyanotic) and 100 age and sex-matched healthy children as a control group. Clinical Evaluation and Laboratory Assessment of Nutritional Status were done. Anthropometric measurements were recorded and Z scores for weight for age (WAZ), weight for height (WHZ) and height for age (HAZ) were calculated. Malnutrition was defined as weight, height and weight/ height z-score ≤ –2.Results: The overall prevalence of malnutrition was 84.0% in patients with CHD and 20% in controls. Severe malnutrition was diagnosed in 71.4% of cases. All anthropometric measurements and levels of biochemical markers of nutritional state were significantly lower in the patients group compared to controls. In patients with acyanotic CHD, stunting was proportionately higher (57.89%) than in cyanotic CHD, while wasting was predominant (45.83%) in the latter. Malnutrition correlated significantly with low hemoglobin level, low arterial oxygen saturation, heart failure, pulmonary hypertension and poor dietary history. Conclusion: Malnutrition is a very common problem in children with symptomatic CHD and predicted by the presence of low hemoglobin level, low arterial oxygen saturation, heart failure, poor dietary history and pulmonary hypertension
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