top of page

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

Go back to main menu

Go back to previous session

Go to next session

References

  1. Tanzanian Standard treatment guideline for children 2017 edition page 85

bottom of page