Heart failure in chidren with SAM

By ULY CLINIC Staff,

Management of Heart failure in children with malutrition

Heart failure is usually a complication of over-hydration. It can also be caused by very severe anaemia.

Clinical signs

Difficulty in breathing
Grunting respiration
An acute increase in RR more than 5 breaths per minute or PR of more
than 25 beats per minute (during rehydration).
Basal lung crepitations
Gallop rhythm
Prominent superficial and neck veins.
A sudden increase in liver size with tenderness
Engorgement of the neck veins when the abdomen (liver) is pressed.
Physical deterioration with a gain in weight.
Increasing oedema or reappearance of oedema during treatment.
An acute fall in haemoglobin concentration.

Treatment of heart failure:

Stop all oral intakes or IV fluids.

Administer frusemide IV 1 mg/kg as a single dose.
Do not give fluid or food until the heart failure has improved (i.e. RR and PR are slower).
Avoid giving digoxin to severely malnourished children

Feeding infants under 6 months

For breastfeeding infant, assist mother to breastfeed or express breast milk.
Give the prescribed amount of feeding in addition to the breast milk.
Give expressed breast milk, F-75 or F-100 diluted for children with or without oedema in that order of preference.

Last updated on 14.09.2020

References