Growth in Children with a Fontan Circulation, finds Study
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A Study was conducted to evaluate growth in a population of patients with Fontan circulation that found variations in height.

Patients were evaluated cross-sectionally by the researchers. Bivariate and multivariate analysis of factors associated with height z-score were conducted using historical data, anthropometry, clinical, and laboratory studies.

Results:
--Patients were included in the study at median age 11.07 years of which 138 had a dominant right systemic ventricle, 92 had hypoplastic left heart syndrome. Median age at completion of Fontan circulation was 31 months. (7.6, 135.8). Median height z-score was -0.58 (-1.75, 0.26).

--25 had current or past history of protein losing enteropathy (PLE). Median height z-score for those with current or past history of PLE was -2.1.

--Multivariate analysis revealed positive associations between height z-score and body mass index (BMI) z-score, time since Fontan, mid-parental height, dominant systemic ventricle type, and serum alkaline phosphatase.

--Height correlated negatively with known genetic syndrome, PLE, use of stimulant or oral steroid medication.

Finally, Children with Fontan circulation have moderate height deficits, while those with protein losing enteropathy (PLE) have larger deficits. The z-score for height improves with time after surgery. Weight loss, which leads to a higher BMI, can be a modifiable factor in improving growth in underweight people. Biochemical markers may be useful in identifying high-risk groups for which interventions should be intensified.

Source: https://www.jpeds.com/article/S0022-3476(21)00345-0/fulltext?rss=yes
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