Thiamine deficiency in children with congenital heart disease before and after corrective surgery

Background: Malnutrition is common in children with congenital heart diseas e, while thiamine deficiency (TD) is common in malnutrition, in critically ill children, and in adults with congestive heart failure treated with loop diuretics. Our goal was to determine whether children with congenital hear t disease had TD and whether treatment with loop diuretics is related to TD in these patients. Methods: Twelve children with ventricular septal defect (VSD) treated with furosemide, and 10 children with tetralogy of Fallot (T OF) referred for corrective surgery were consecutively enrolled into a pros pective study. Data were collected 24 hours before surgery and 5 days after surgery for nutrition evaluation, medications used, anthropometric measure ments, and laboratory markers of malnutrition. Thiamine and pyridoxine defi ciencies were evaluated using activated enzyme assays. Results: Seven child ren (32% of patients) did not meet the recommended daily allowance (RDA) fo r calories and 18% of patients did not meet the RDA for thiamine intake. An thropometric measurements were low in both groups, more so in those with VS D, although the difference did not reach statistical significance. Overall, 18% (1/12 with VSD and 3/10 with TOF) of children with congenital heart: d isease had thiamine deficiency before surgery. Three of the four children w ith TD had adequate intake of thiamine. Six children (27%) had TD 5 days po stsurgery (3 children with VSD and 3 children with TOF). Conclusions: TD is common in children with congenital heart disease (CID) referred for correc tive surgery both before and after surgery. Our results suggest that neithe r diuretic treatment nor malnutrition can fully explain the development of TD in these children.