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# Cardiopatia Congenita: 58 - Cardiovascular circulation - Anorexia - Dysphagia - Malabsorption intestinal - Stress response - Inadequate caloric intake - Circulation: - The pulmonary (right ventricle) is thicker because it requires more force. - Pulmonary artery: carrie...

# Cardiopatia Congenita: 58 - Cardiovascular circulation - Anorexia - Dysphagia - Malabsorption intestinal - Stress response - Inadequate caloric intake - Circulation: - The pulmonary (right ventricle) is thicker because it requires more force. - Pulmonary artery: carries blood without oxygen. - Pulmonary vein: carries blood with oxygen. - In the uterus, there is no lung function, the blood vessels remain closed until birth. - Umbilical vein: carries oxygenated blood from the mother. - Cardiopaths: open heart ducts (combination of arterial and venous blood) - Heart development: coronary heart development begins at 6 weeks of gestation. - Treatment: Surgery (for congenital heart defects) - Nutritional status: - Delayed growth and development. - Loss of appetite and early satiety - Patients with chronic hypoxia, severe heart failure, hypertension, and malnutrition. - Risk factors: Congenital malnutrition - Increase in the basal metabolic rate (BMR) - Hypermetabolic - Infections - Greater loss of nutrients. ## Management of Nutrition - Adequate caloric-protein - Sodium and fluid restriction, potassium, and fats. - Vitamin and mineral supplements such as iron and calcium. - Calories: 220 kcal/kg/day - Protein: 4 g/kg/day - Total: 165 ml/kg/day # Pediatric Kidneys: 59 - Renal System: Blood filtration, residue elimination, fluid regulation, hormone production (erythropoietin, regulation of blood pH). - Nephrotic Syndrome: Loss of large amounts of protein in the urine. It causes low blood protein, hypoalbuminemia, edema, and hyperlipidemia. - Hypoalbuminemia: < 2.5 g/dl - Edema - Hyperlipidemia - Proteinuria: 350 mg/kg/day - Nutritional management: - Normal protein intake; no increase (hypoalbuminemia) - Avoid salt and processed food. - Low-fat dairy - Lean meats # Nephritic Syndrome Inflammatory: - Glomeruli inflammation and kidney damage. - Edema - Hematuria: blood in the urine. - Oliguria: low urine volume. - Proteinuria: 750 mg/kg/day. ## Nutritional Management - Protein restriction and phosphorus. - Hypoprotein diet (1.66 g/kg/day; 0.6 - 1.91 kg/day) - Hyposodic diet. # Chronic Renal Failure: - Kidney alterations for 73 months. - Goal: Promote renal desnutrition. - Inadequate intake - Loss of protein due to dialysis. # Pneumopathies: 510 - The main function of the respiratory system is gas exchange (alveoli-capillaries). - Affects the pulmonary parenchyma: muscle mass, strength, and respiratory tolerance. # Bronchial Asthma - Chronic inflammatory pulmonary disease that affects the airways, causing an allergic reaction. - It affects the immune system and is not curable. ## Pathophysiology - Airway obstruction. - Inflammation - Bronchial hyperactivity - Atopic asthma - Vasodilation - Bronchoconstricion - Hypersecretion - Otitis Media ## Diagnosis - Allergy mediated by IgE - Asthma and overweight: increased probability of having nasal symptoms. ## Nutritional Management - If necessary, a hypocaloric diet. - Choosing healthy foods. - Physical activity - Restriction of chocolate, sodas, and sweets. - Medications can cause vomiting, diarrhea, and sodium retention. ## Pneumonia - Infection of the lungs caused by viruses, bacteria, and fungi. - Colds # Leukemia: 514 - White blood cells: transports oxygen. - Leukemic white blood cells: defective. - Lymphocytes: coagulation (4) - Risk factors: extreme ages, male sex, genes, exposure to insecticides. - Signs and symptoms: fatigue, anorexia, bone pain, hematomas, pallor, irritability. - Diagnosis: hemogram and bone marrow biopsy. - (Protein irrigation of red blood cells) - Metabolic alterations: loss of body fat, muscle mass loss, hypoalbuminemia, atrophy of internal organs. - There is increased glucose consumption. - Loss of weight. - Hypocalcemia: undernutrition - Hypercalcemia: tumors - Types of treatment: Chemotherapy, radiotherapy, surgery. - Nutritional treatment: - Goal: improve quality of life. - Improve immunological status. - Avoid/correct nutritional deficiencies. - Hospital discharge # Diet - Low microbial load diet due to the immune system's low activity. - Nutritional support: - Causes of weight loss: > 5% - PIT < 90% CPIO (Protein and Calorie Intake) - Serum albumin < 32 gr/dl - Initial or continuous formulas. # Short bowel syndrome - Characterized by the loss of a segment of the small intestine, causing an inability to absorb nutrients. - Intestinal failure: First nutritional option. ## Intestinal Trophism: - 1 cc/kg/day - Amount of protein in transplantation - Transplantation. # Enteral nutrition: 511 - Nutritional support provided directly to the gastrointestinal tract through supplements. - It is used when the patient cannot swallow. - When the gastrointestinal tract is unable to function properly. ## Indications: - When the patient cannot swallow. - When the gastrointestinal tract cannot function properly. # Transplant: 514 - Phases: - Pre-transplant: low microbial diet, nutritional support - During transplant: nasogastric tube or jejunostomy - Post-transplant: parenteral nutrition 24-36 hours later. - After transplantation: enteral nutrition, diet low in bacterial load and high protein content ## Protein: - Pre-transplant: 1.2 g - Post-intermediate: 1.5-2.0 g - Post-transplant: 1.2 g ## Formulas - By nutrients: - Polymeric: intact nutrients. - Peptides: semi-digested. - Elemental. - Polymeric: for gastric patients, not applicable in the jejunum. ## Elements: - Semi-digested (jejunum) - Elemental (ilium). ## By Energy Density - Standard: 1 kcal/ml - Hyper: 1.5-2 - Hypo: 1 - Hyperprotein. ## Administration - Bolus: for acute/severe conditions. - Intermitent: when absorption is good/regular. - Continuous: regulated.