Successful Treatment of Severe Intractable Diarrhea and Malnutrition in a Child with Dilated Cardiomyopathy Bridged to Left Ventricular Assist Device from Extracorporeal Cardiopulmonary Resuscitation

Öz:

An increasing number of pediatric patients with dilated cardiomyopathy (DCMP) undergo mechanical circulatory support (MCS), as a bridge to heart transplantation. Gastrointestinal complications in this population are rare, and the treatment is challenging. Patients with DCMP frequently present with heart failure symptoms, such as tachycardia, hypotension, respiratory distress, cyanosis, weak peripheral pulses, and inadequate feed. Rarely, gastrointestinal symptoms, such as nausea and ascites, may be noted if biventricular failure develops. Here we present a case of a 14-year-old girl with severe intractable diarrhea and malnutrition after being diagnosed with DCMP. After extracorporeal cardiopulmonary resuscitation, she was bridged to a long-term left ventricular assist device support. Her recovery was complicated with intractable diarrhea and malnutrition, which were critical. Thus, this case study aimed to emphasize that pediatric patients with DCMP having persistent diarrhea and malnutrition can be successfully treated with MCS.

Anahtar Kelime:

Ekstrakorporeal Kardiyopulmoner Resüsitasyondan Sol Ventriküler Yardım Cihazına Köprülenmiş Dilate Kardiyomiyopatili Bir Çocukta Şiddetli İnatçı Diyare ve Malnutrisyonun Başarılı Tedavisi

Öz:

Dilate kardiyomiyopatili (DKMP) çocuk hasta grubunda, kalp transplantasyonuna köprü olmayı amaçlayan mekanik dolaşım desteğine (MDD) ihtiyaç vardır. Bu popülasyonda gastrointestinal komplikasyonlar nadirdir ve tedavisi zordur. DKMP’li hastalar sıklıkla taşikardi, hipotansiyon, solunum sıkıntısı, siyanoz, zayıf periferik nabızlar ve beslenme isteksizliği gibi kalp yetersizliği semptomları ile başvururlar. Nadiren, biventriküler yetmezlik gelişirse mide bulantısı ve asit gibi gastrointestinal semptomlar görülebilir. Bu çalışmada, DKMP tanısı konulduktan sonra şiddetli, inatçı diyare ve yetersiz beslenmesi olan 14 yaşında bir kız çocuğunu sunuyoruz. Ekstrakorporeal kardiyopulmoner resüsitasyon sonrası uzun süreli sol ventrikül destek cihazı desteği sunulmuştur. İnatçı diyare ve malnütrisyonu olan DKMP çocuk hastaların MDD ile başarılı bir şekilde tedavi olduğunu vurgulamayı amaçlıyoruz.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Olgu Sunumu Erişim Türü: Erişime Açık

1. Richardson P, McKenna W, Bristow M, Maisch B, Mautner B, et al. Report of the 1995 World Health Organization/International Society and Federation of Cardiology Task Force on the Definition and Classification of cardiomyopathies. Circulation. 1996;93:841-2.
2. Elliott P, Andersson B, Arbustini E, Bilinska Z, Cecchi F, et al. Classification of the cardiomyopathies: a position statement from the European Society Of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J. 2008;29:270-6.
3. Nikolaou M, Parissis J, Yilmaz MB, Seronde MF, Kivikko M, et al. Liver function abnormalities, clinical profile, and outcome in acute decompensated heart failure. Eur Heart J. 2013;34:742-9.
4. Rogler G, Rosano G. The heart and the gut. Eur Heart J. 2014;35:426-30.
5. Toda K, Fujita T, Seguchi O, Yanase M, Nakatani T. Role of percutaneous veno-arterial extracorporeal membrane oxygenation as bridge to left ventricular assist device. J Artif Organs. 2018;21:39- 45.
6. Sandek A, Bauditz J, Swidsinski A, Buhner S, Weber-Eibel J, et al. Altered intestinal function in patients with chronic heart failure. J Am Coll Cardiol. 2007;50:1561-9.
7. Valentova M, von Haehling S, Bauditz J, Doehner W, Ebner N, et al. Intestinal congestion and right ventricular dysfunction: a link with appetite loss, inflammation, and cachexia in chronic heart failure. Eur Heart J. 2016;37:1684-91.
8. Verbrugge FH, Dupont M, Steels P, Grieten L, Malbrain M, et al. Abdominal contributions to cardiorenal dysfunction in congestive heart failure. J Am Coll Cardiol. 2013;62:485-95.
9. Suzuki N, Kida K, Suzuki K, Harada T, Akashi YJ. Assessment of transthyretin combined with mini nutritional assessment on admission provides useful prognostic information in patients with acute decompensated heart failure. Int Heart J. 2015;56:226-33.
10. Hetzer R, Javier MFDM, Delmo Walter EM. Role of paediatric assist device in bridge to transplant. Ann Cardiothorac Surg. 2018;7:82- 98.
11. Bhatia I, Ho KC, Rocha BA, Yam N, Lun KS, et al. Pediatric ventricular assist device therapy for advanced heart failure-Hong Kong experience. J Artif Organs. 2020;23:133-9.
12. Schweiger M, Vanderpluym C, Jeewa A, Canter CE, Jansz P, et al. Outpatient management of intra-corporeal left ventricular assist device system in children: a multi-center experience. Am J Transplant. 2015;15:453-60.

APA	botan e, KENDIRLI T, Gün E, RAMOĞLU M, UÇAR T, Sarıcaoğlu M, Tuna Kırsaçlıoğlu C, Kuloglu Z, İnce E, Akar A (2022). Successful Treatment of Severe Intractable Diarrhea and Malnutrition in a Child with Dilated Cardiomyopathy Bridged to Left Ventricular Assist Device from Extracorporeal Cardiopulmonary Resuscitation. , 47 - 50. 10.4274/cayd.galenos.2021.33154
Chicago	botan edin,KENDIRLI TANIL,Gün Emrah,RAMOĞLU Mehmet Gökhan,UÇAR TAYFUN,Sarıcaoğlu Mehmet Cahit,Tuna Kırsaçlıoğlu Ceyda,Kuloglu Zarife,İnce Erdal,Akar Ahmet Ruchan Successful Treatment of Severe Intractable Diarrhea and Malnutrition in a Child with Dilated Cardiomyopathy Bridged to Left Ventricular Assist Device from Extracorporeal Cardiopulmonary Resuscitation. (2022): 47 - 50. 10.4274/cayd.galenos.2021.33154
MLA	botan edin,KENDIRLI TANIL,Gün Emrah,RAMOĞLU Mehmet Gökhan,UÇAR TAYFUN,Sarıcaoğlu Mehmet Cahit,Tuna Kırsaçlıoğlu Ceyda,Kuloglu Zarife,İnce Erdal,Akar Ahmet Ruchan Successful Treatment of Severe Intractable Diarrhea and Malnutrition in a Child with Dilated Cardiomyopathy Bridged to Left Ventricular Assist Device from Extracorporeal Cardiopulmonary Resuscitation. , 2022, ss.47 - 50. 10.4274/cayd.galenos.2021.33154
AMA	botan e,KENDIRLI T,Gün E,RAMOĞLU M,UÇAR T,Sarıcaoğlu M,Tuna Kırsaçlıoğlu C,Kuloglu Z,İnce E,Akar A Successful Treatment of Severe Intractable Diarrhea and Malnutrition in a Child with Dilated Cardiomyopathy Bridged to Left Ventricular Assist Device from Extracorporeal Cardiopulmonary Resuscitation. . 2022; 47 - 50. 10.4274/cayd.galenos.2021.33154
Vancouver	botan e,KENDIRLI T,Gün E,RAMOĞLU M,UÇAR T,Sarıcaoğlu M,Tuna Kırsaçlıoğlu C,Kuloglu Z,İnce E,Akar A Successful Treatment of Severe Intractable Diarrhea and Malnutrition in a Child with Dilated Cardiomyopathy Bridged to Left Ventricular Assist Device from Extracorporeal Cardiopulmonary Resuscitation. . 2022; 47 - 50. 10.4274/cayd.galenos.2021.33154
IEEE	botan e,KENDIRLI T,Gün E,RAMOĞLU M,UÇAR T,Sarıcaoğlu M,Tuna Kırsaçlıoğlu C,Kuloglu Z,İnce E,Akar A "Successful Treatment of Severe Intractable Diarrhea and Malnutrition in a Child with Dilated Cardiomyopathy Bridged to Left Ventricular Assist Device from Extracorporeal Cardiopulmonary Resuscitation." , ss.47 - 50, 2022. 10.4274/cayd.galenos.2021.33154
ISNAD	botan, edin vd. "Successful Treatment of Severe Intractable Diarrhea and Malnutrition in a Child with Dilated Cardiomyopathy Bridged to Left Ventricular Assist Device from Extracorporeal Cardiopulmonary Resuscitation". (2022), 47-50. https://doi.org/10.4274/cayd.galenos.2021.33154

APA	botan e, KENDIRLI T, Gün E, RAMOĞLU M, UÇAR T, Sarıcaoğlu M, Tuna Kırsaçlıoğlu C, Kuloglu Z, İnce E, Akar A (2022). Successful Treatment of Severe Intractable Diarrhea and Malnutrition in a Child with Dilated Cardiomyopathy Bridged to Left Ventricular Assist Device from Extracorporeal Cardiopulmonary Resuscitation. Çocuk Acil ve Yoğun Bakım Dergisi, 9(1), 47 - 50. 10.4274/cayd.galenos.2021.33154
Chicago	botan edin,KENDIRLI TANIL,Gün Emrah,RAMOĞLU Mehmet Gökhan,UÇAR TAYFUN,Sarıcaoğlu Mehmet Cahit,Tuna Kırsaçlıoğlu Ceyda,Kuloglu Zarife,İnce Erdal,Akar Ahmet Ruchan Successful Treatment of Severe Intractable Diarrhea and Malnutrition in a Child with Dilated Cardiomyopathy Bridged to Left Ventricular Assist Device from Extracorporeal Cardiopulmonary Resuscitation. Çocuk Acil ve Yoğun Bakım Dergisi 9, no.1 (2022): 47 - 50. 10.4274/cayd.galenos.2021.33154
MLA	botan edin,KENDIRLI TANIL,Gün Emrah,RAMOĞLU Mehmet Gökhan,UÇAR TAYFUN,Sarıcaoğlu Mehmet Cahit,Tuna Kırsaçlıoğlu Ceyda,Kuloglu Zarife,İnce Erdal,Akar Ahmet Ruchan Successful Treatment of Severe Intractable Diarrhea and Malnutrition in a Child with Dilated Cardiomyopathy Bridged to Left Ventricular Assist Device from Extracorporeal Cardiopulmonary Resuscitation. Çocuk Acil ve Yoğun Bakım Dergisi, vol.9, no.1, 2022, ss.47 - 50. 10.4274/cayd.galenos.2021.33154
AMA	botan e,KENDIRLI T,Gün E,RAMOĞLU M,UÇAR T,Sarıcaoğlu M,Tuna Kırsaçlıoğlu C,Kuloglu Z,İnce E,Akar A Successful Treatment of Severe Intractable Diarrhea and Malnutrition in a Child with Dilated Cardiomyopathy Bridged to Left Ventricular Assist Device from Extracorporeal Cardiopulmonary Resuscitation. Çocuk Acil ve Yoğun Bakım Dergisi. 2022; 9(1): 47 - 50. 10.4274/cayd.galenos.2021.33154
Vancouver	botan e,KENDIRLI T,Gün E,RAMOĞLU M,UÇAR T,Sarıcaoğlu M,Tuna Kırsaçlıoğlu C,Kuloglu Z,İnce E,Akar A Successful Treatment of Severe Intractable Diarrhea and Malnutrition in a Child with Dilated Cardiomyopathy Bridged to Left Ventricular Assist Device from Extracorporeal Cardiopulmonary Resuscitation. Çocuk Acil ve Yoğun Bakım Dergisi. 2022; 9(1): 47 - 50. 10.4274/cayd.galenos.2021.33154
IEEE	botan e,KENDIRLI T,Gün E,RAMOĞLU M,UÇAR T,Sarıcaoğlu M,Tuna Kırsaçlıoğlu C,Kuloglu Z,İnce E,Akar A "Successful Treatment of Severe Intractable Diarrhea and Malnutrition in a Child with Dilated Cardiomyopathy Bridged to Left Ventricular Assist Device from Extracorporeal Cardiopulmonary Resuscitation." Çocuk Acil ve Yoğun Bakım Dergisi, 9, ss.47 - 50, 2022. 10.4274/cayd.galenos.2021.33154
ISNAD	botan, edin vd. "Successful Treatment of Severe Intractable Diarrhea and Malnutrition in a Child with Dilated Cardiomyopathy Bridged to Left Ventricular Assist Device from Extracorporeal Cardiopulmonary Resuscitation". Çocuk Acil ve Yoğun Bakım Dergisi 9/1 (2022), 47-50. https://doi.org/10.4274/cayd.galenos.2021.33154