WATER INTAKE - with MUDr. Martin Záhorec, PhD.
Children with single ventricle hearts should drink plenty of water throughout the day. But, what is plenty? I never gave it a second thought. Until recently. We visited a nephrologist to deal with our daughter's incontinence. After she successfully passed a computerized toilet test and some other check-ups, the conclusion was that she might be simply drinking too much. First step, they advised, is to reduce the water intake. But, how safe is it to drink less for her heart?
Embex - www.embex.sk
MUDr. Martin Záhorec, PhD. is a pediatric cardiologist, specialized in paediatric intensive care. He is a Head of Paediatric Cardiology Department at the Paediatric Cardiac Center in Bratislava, Slovakia:
Generally said, kids with a single ventricle are more sensitive to water underload than kids with two ventricles. Unsatisfactory hydration could be even dangerous for them.
As he explains, children with a single ventricle heart may be prone to thrombosis*; often their blood is "thicker" as less oxygen triggers more red blood cells production from bone marrow; they have often inherited disbalance of different clotting factors in blood; their blood flow is more turbulent (for example in artificial shunts and vessel connections) and/or slower (passive lung flow in Glenn and Fontan circuit).
This is the background for physicians recommendations to maintain adequate hydration in every situation, all over the year. But most importantly when kids get sick with fever, diarrhea, vomiting etc., and during hot summer days.
- infants 3.5 to 10 kg = 100 mL/kg
- children 11-20 kg = 1000 mL + 50 mL/kg for every kg over 10
- children >20 kg = 1500 mL + 20 mL/kg for every kg over 20
(up to a maximum of 2400 mL daily, including the fluid from meals like a soup, fruits, vegetables, etc.)
A lot also depends on the fluid output of a particular child during the day.
There are situations when too much fluid can harm the patient with a single ventricle. Mainly when the heart muscle starts to fail or when other, quite rare long-term complications after Fontan develop (protein losing enteropathy*, effusions*, ascites*). In those situations often diuretics are prescribed to support sufficient urine output.
*THROMBOSIS - clot formation
*PROTEIN-LOSING ENTEROPATHY - a condition in which excess loss of proteins occurs through the gastrointestinal tract
*EFFUSION - accumulation of fluid in a body cavity
*ASCITES - the build-up of fluid in the belly
Medical Disclaimer
This article is for informational or educational purposes only. It does not substitute professional medical advice, diagnosis or treatment. Always seek the advice of a physician or other qualified health provider.