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Management of SAM in a child with Pulmonary hypertension

This question was posted the Management of wasting/acute malnutrition forum area and has 6 replies.

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Anonymous_A_W_40

Nutritionist/ M40Re Analytics

Normal user

13 Mar 2023, 05:10

Hello, How do you manage a child 2 years with pulmonary hypertension and SAM; are there any special considerations or you manage as other SAM children?

Any input will be highly appreciated.

Regards.

Jay Berkley

Professor

Frequent user

14 Mar 2023, 08:41

If, in general, pulmonary hypertension or other cardiac conditions are stable, the child is not on any treatment and there are no other complications at the time and the child has wasting only, then standard antibiotics and thereapetutic feeds should not be a problem. However, it is likely that the wasting is likely partially due to the cardiac condition so the care plan should include early cardiac review.

If the condition is not stable, or there is oedema or hypoxia, the child needs an urgent expert opinion as  this will depend very much on details of the condition and the facilities and expertise available at your centre. I think the forum is not the right place for discussion of an individual patient's care for a complex condition.

I am happy for

BRIAN NAMBALE

AP-RN / Infectious Diseases Institute

Normal user

14 Mar 2023, 10:54

Have you thought about a low dose of Sednafil along Side the nutritional care?

This can improve the quality of life 

Anonymous_A_W_40

Nutritionist/ M40Re Analytics

Normal user

14 Mar 2023, 14:32

Thank you for the response @ Jay Berkley

Dieudonne Bikorimana

MD-Critical care

Normal user

15 Mar 2023, 05:31

Even in the absence of a specialist, it will be necessary to think about the management of this cardiac pathology and to evaluate its part in the overall situation.

Very useful question: How to diagnose pulmonary hypertensia?

Where is the key?

Check the kind of edema.

Anonymous_A_W_40

Nutritionist/ M40Re Analytics

Normal user

15 Mar 2023, 15:44

Thank you @ Brian Nambale for your response..Yes child is on low dose sednafil. My main concern was on the therapeutic feeds because of the electrolytes and pulmonary edema.

Anonymous_A_W_40

Nutritionist/ M40Re Analytics

Normal user

15 Mar 2023, 15:52

Thank you@ Dieudonne Bikorimana for your response.

For us we diagnose pulmonary hypertension using ECHO ( Echocardiogram) and also checking the Pulmonary artery pressures.

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