Abstract 20391: Fluid Overload in Children Hospitalized With Heart Failure: How Common and How Much?
Background: Studies suggest it is uncommon for children hospitalized with acute decompensated heart failure (ADHF) to present with overt signs of fluid overload (FO). It is unclear whether children hospitalized with HF actually have fluid overload, and if so, what the magnitude of fluid overload is. We sought to determine the prevalence and magnitude of FO in children hospitalized with heart failure.
Methods: All children age <21 years hospitalized with ADHF over an 18-month period between 2014 and 2015 were identified using a hospital database. The degree of FO was estimated by calculating the difference in body weight from admission to lowest weight.
Results: Between February 2014 and October 2015, 50 children underwent 70 hospitalizations for ADHF. The median age at admission was 13 years (IQR 2, 16), median weight 33 kg (11, 68); median BMI 19 (17, 24; including 10% with BMI>30); 50% had congenital heart disease (including 30% with single ventricle disease); ventricular function was preserved in 32%, moderately depressed in 16% and severely depressed in 51%. Overall, children lost an average of 7% (S.D ±7%) body weight between admission and their lowest weight (range 0 to 34%). The average decrease in BMI was 7% [1.5 kg/m2 (S.D ±7%)] with a range of 0 to 37% (0 to 9 kg/m2). Whereas one in 10 children (N=6) satisfied BMI criteria for obesity at presentation, one-third (N=2) no longer met criteria for obesity after diuresis.
Conclusion: Although children hospitalized with HF often do not manifest signs of fluid overload, they have significant fluid overload that is consistent in magnitude with adult patients hospitalized with HF. Because BMI may fluctuate significantly, caution should be used when interpreting BMI in the context of transplant candidacy decisions.
- Pediatric cardiology
- Heart failure, pediatric
- Transplantation/medical aspects
- Acute heart failure
Author Disclosures: J.C. Dykes: None. J.F. Kruger: None. B.D. Kaufman: None. E. Liu: None. K.M. Dennis: None. A.K. Kipps: None. V.V. Yarlagadda: None. S. Chen: None. S.A. Hollander: None. D.N. Rosenthal: None. C.S. Almond: None.
- © 2016 by American Heart Association, Inc.