Research On The Perioperative Resting Energy Expenditure And Body Composition In Children With Congenital Heart Disease

OBJECTIVE: The purpose of this study is to longitudinally observe the body composition and resting energy expenditure(REE)changing rules and the possible influencing factorsin children with CHD by using indirect calorimetry(IC)and bioelectric impedance analysis(BIA).METHODS: The patients' body compositions were measured via bioelectric impedance analysis(BIA)on the day before operation day,the 1st day and 7th day post-operaration,respectively.The REE were also measured using the indirect calorimetry(IC)at the same time points.A total of 75 age and gender matched children under normal nutritional status were enrolled into the control group.RESULTS:Body composition studies showed the percentage of body cell mass(BCM)in CHD group was significantly lower than that in the control group.The total body water(TBW)content of CHD group was significantly higher than that in the control group.TBW,ECW contents and edema index(EI)increased on the 1st day after surgery and then went back to the pre-operative level on the 7th day after surgery,the agreement was poor between REE and PEE.CONCLUSIONS:The incidence of malnutrition in the CHD group was high.The BCM of CHD group was significantly lower than that in the control group.The content of TBW,ECW and ICW in the CHD group were higher than those in the control group before surgery.Phase angle may be one of the sensitive indicator of nutrition assessment index in children with CHD.The PEE formulas currently used were less consistent with the REE in CHD children.The influence factors on post-operative REE are complex.BIA and IC is suggested to be used in conditions,to assess the nutrition status and energy requirements of CHD children.The optimal and individual nutrition support therapy should be given to children with CHD,and then improve the nutrition status and clinical outcomes.