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Clinical Pediatrics
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Cardiac Function in Malnourished Children

Chalie Phornphatkul

Department of Pediatrics, Chiang Mai University Medical School, Chiang Mai, Thailand

Yupada Pongprot

Department of Pediatrics, Chiang Mai University Medical School, Chiang Mai, Thailand

Robert Suskind

Department of Pediatrics, Louisiana State University Medical School, New Orleans, Louisiana

Varghese George

Department of Biometry and Genetics, Louisiana State University School Medical Center, New Orleans, Louisiana

George Fuchs

Department of Pediatrics, Chiang Mai University Medical School, Chiang Mai, Thailand, Department of Pediatrics, Louisiana State University Medical School, New Orleans, Louisiana

The cardiovascular status of severely malnourished children was characterized before, during, and after nutritional rehabilitation. In most children with third-degree malnutrition, cardiac mass was decreased on admission to the hospital and recovered subsequent to nutritional therapy. All children had echocardiographic and Doppler measurements indicative of impaired ventricular function which significantly improved during the course of hospitalization, as evidenced in part by the change in fractional shortening (P= 0.015), mean velocity of circumferential fiber shortening (P= 0.038), and systolic time interval (P = 0.030). We conclude that children with primary third-degree malnutrition not only have cardiac muscle wasting, but also have inherent ventricular dysfunction as the result of severe malnutrition that responds to nutritional therapy. Particular care with fluid administration is imperative in the first week of therapy, when heart function is the most compromised.

Clinical Pediatrics, Vol. 33, No. 3, 147-154 (1994)
DOI: 10.1177/000992289403300304
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