Fractures Related to Metabolic Bone Disease in Children with Congenital Heart Disease

Cheng, Henry; Carmona, Fábio; McDavitt, Erica; Wigmore, Daniel; Peréz-Rosselló, Jeannette M.; Gordon, Catherine M.; Pigula, Frank A.; Laussen, Peter C.; Rajagopal, Satish

doi:10.1111/chd.12293

Cited by 13 publications

(23 citation statements)

References 13 publications

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“…In a small and limited retrospective study, Cheng et al reviewed the medical records of children admitted to a cardiac intensive care unit to characterize a cohort of patients with congenital heart defects and fractures, and the researchers described a fragile bone protocol to reduce fractures. 31 The study found 2 fracture cases per 1000 admissions (15 patients with 23 fractures), with 87% sustaining fractures after surgery (mean age, 6 months; range, 2-23 months). Alterations to the homeostatic balance of parathyroid hormone and vitamin D were commonly seen in patients: 77% of patients had hyperparathyroidism; 40% had hypovitaminosis D (despite being supplemented to 400 U/d); and 33% had both.…”

Section: Vitamin D and Calciummentioning

confidence: 90%

“…Critically ill patients with HF may be at risk for developing metabolic bone disease and subsequent fractures. They have cumulative exposures to several risk factors, such as vitamin D deficiency, renal insufficiency, poor nutrition, immobilization, and effects of certain medications (eg, diuretics) . Additionally, they may have hyperparathyroidism and decreased calcitrol levels.…”

Section: Macronutrients and Micronutrients In Hfmentioning

confidence: 99%

“…Additionally, they may have hyperparathyroidism and decreased calcitrol levels. In a small and limited retrospective study, Cheng et al reviewed the medical records of children admitted to a cardiac intensive care unit to characterize a cohort of patients with congenital heart defects and fractures, and the researchers described a fragile bone protocol to reduce fractures . The study found 2 fracture cases per 1000 admissions (15 patients with 23 fractures), with 87% sustaining fractures after surgery (mean age, 6 months; range, 2–23 months).…”

Section: Macronutrients and Micronutrients In Hfmentioning

confidence: 99%

“…The study found 2 fracture cases per 1000 admissions (15 patients with 23 fractures), with 87% sustaining fractures after surgery (mean age, 6 months; range, 2–23 months). Alterations to the homeostatic balance of parathyroid hormone and vitamin D were commonly seen in patients: 77% of patients had hyperparathyroidism; 40% had hypovitaminosis D (despite being supplemented to 400 U/d); and 33% had both …”

Section: Macronutrients and Micronutrients In Hfmentioning

confidence: 99%

“…They have cumulative exposures to several risk factors, such as vitamin D deficiency, renal insufficiency, poor nutrition, immobilization, and effects of certain medications (eg, diuretics). 31 Additionally, they may have hyperparathyroidism and decreased calcitrol levels. In a small and limited retrospective study, Cheng et al reviewed the medical records of children admitted to a cardiac intensive care unit to characterize a cohort of patients with congenital heart defects and fractures, and the researchers described a fragile bone protocol to reduce fractures.…”

Section: Vitamin D and Calciummentioning

confidence: 99%

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

et al. 2017

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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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Section: Vitamin D and Calciummentioning

confidence: 90%

Section: Macronutrients and Micronutrients In Hfmentioning

confidence: 99%

Section: Macronutrients and Micronutrients In Hfmentioning

confidence: 99%

Section: Macronutrients and Micronutrients In Hfmentioning

confidence: 99%

Section: Vitamin D and Calciummentioning

confidence: 99%

See 3 more Smart Citations

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

et al. 2017

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Low bone mineral density and its related factors in adults with congenital heart disease in Vietnam: A cross‐sectional study

Truong

Nguyen

Kim

et al. 2022

Health Science Reports

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Background and Aims Recent studies have highlighted the increased risk of low bone mineral density (BMD) in adults with cardiovascular disease. However, little is known about BMD in adults with congenital heart disease (CHD), particularly in developing countries. We hypothesized that factors related to BMD would lead to a high prevalence of low BMD in adults with CHD. This study aimed to determine the prevalence of low BMD and its related factors in Vietnamese adults with CHD. Methods We conducted a cross‐sectional study of 73 adults diagnosed with CHD in Vietnam. Low BMD was classified based on their site‐specific Z ‐scores and T ‐scores at the posteroanterior lumbar spine and left proximal femur. Logistic regression analyses were performed to evaluate factors related to low BMD. Results Low BMD was confirmed in one‐third of the adults with CHD. There were trends of more bone loss in certain parts of the body than in others, with the prevalence of low BMD at the sites of the lumbar vertebrae (L1‒L4) and left proximal femur (femoral neck, trochanteric femur, and intertrochanteric area) of 43.9%, 31.8%, 28.8%, 33.3%, 8.8%, 1.5%, and 6.1%, respectively. The prevalence of low BMD in the lumbar spine was significantly higher than that in the left proximal femur (34.3% vs. 2.9%, p < 0.001). Moreover, the prevalence of low BMD was significantly higher in adults with CHD than in those without polycythemia and vitamin D deficiency (55.6% vs. 20.9%, p = 0.001 and 46.2% vs. 19.4%, p = 0.002, respectively). A stratified multivariate logistic regression analysis revealed that low BMD was associated with polycythemia (odds ratio: 4.72; 95% confidence interval: 1.64–13.58, p = 0.004). Conclusions Low BMD is common among adults with CHD in Vietnam and related to polycythemia.

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Vitamin D, rickets and child abuse: controversies and evidence

Sierra

Christian

2021

Pediatr Radiol

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Fractures Related to Metabolic Bone Disease in Children with Congenital Heart Disease

Cited by 13 publications

References 13 publications

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

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

Low bone mineral density and its related factors in adults with congenital heart disease in Vietnam: A cross‐sectional study

Vitamin D, rickets and child abuse: controversies and evidence

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