https://doi.org/10.4081/ecj.2024.13186

Extreme nutritional neglect leading to cardiac arrest in a child: a rare presentation of severe acute malnutrition in England

Early Access
Submitted: 1 October 2024
Accepted: 7 November 2024
Published: 17 December 2024
Case report, malnutrition, resuscitation, neglect, safeguarding
Abstract Views: 239
PDF: 75
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Authors

Ashley Reed
Ashleyreed@nhs.net
https://orcid.org/0000-0001-5021-6641
Consultant Practitioner in Emergency Care, Southend University Hospital, Mid and South Essex NHS Trust, United Kingdom.
Mohamed Bar
https://orcid.org/0009-0003-0809-6334
Paediatric Trainee, Southend University Hospital, Mid and South Essex NHS Trust, United Kingdom.

This case report from England describes an 8-year-old girl who suffered severe health complications culminating in cardiac arrest due to profound neglect and malnutrition. The patient presented with cardiac arrest, which was attributed to her severe wasting. Upon admission, her body mass index measured 12.8 kg/m2 (z-score ranging between -2 and -3), indicative of severe malnutrition. The patient presented with respiratory, renal, and hepatic failure, in addition to disseminated intravascular coagulation. Resuscitative measures were administered, and she underwent 162 hours of ventilation in the paediatric intensive care unit. Despite the gravity of her initial presentation, the patient exhibited a notable recovery. Paediatric cardiac arrest stemming from extreme nutritional neglect is a rare occurrence in England. This case underscores the paramount importance of prompt intervention and comprehensive medical oversight. The patient's relatively favourable recovery underscores the potential for positive outcomes when timely and appropriate medical interventions are employed.

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Citations

Crossref
Scopus
Google Scholar
Europe PMC
Royal College of Paediatrics and Child Health. UK-WHO growth charts - 2-18 years. 2018.
World Health Organization. Growth Reference 5-19 Years - BMI-for-age (5-19 years). 2007.
Ons.gov.uk. Deaths from malnutrition - Office for National Statistics. 2023.
Solarino B, Tsokos M, Di Vella G, Tattoli L. Child Starvation and Neglect. In: Handbook of Famine, Starvation, and Nutrient Deprivation. 2019:961–79. DOI: https://doi.org/10.1007/978-3-319-55387-0_57
Thakur N, Chandra J, Pemde H, Singh V. Anemia in severe acute malnutrition. Nutrition 2014;30:440–2. DOI: https://doi.org/10.1016/j.nut.2013.09.011
Langeland H, Damås JK, Mollnes TE, et al. The inflammatory response is related to circulatory failure after out-of-hospital cardiac arrest: A prospective cohort study. Resuscitation. 2022;170:115–25. DOI: https://doi.org/10.1016/j.resuscitation.2021.11.026
Benabe JE, Martinez-Maldonado M. The Impact of Malnutrition on Kidney Function. Miner Electrolyte Metab 1997;24:20–6. DOI: https://doi.org/10.1159/000057346
Soeters PB, Wolfe RR, Shenkin A. Hypoalbuminemia: Pathogenesis and clinical significance. J Parenter Enter Nutr 2018;43:181–93. DOI: https://doi.org/10.1002/jpen.1451
Arya AK, Kumar P, Midha T, Singh M. Hematological profile of children with severe acute malnutrition: a tertiary care centre experience. Int J Contemp Pediatr 2017;4:1577. DOI: https://doi.org/10.18203/2349-3291.ijcp20173072
De Silva A, Nightingale JMD. Refeeding syndrome: physiological background and practical management. Frontline Gastroenterol 2019;11:404–9. DOI: https://doi.org/10.1136/flgastro-2018-101065
Titi-Lartey OA, Gupta V. Marasmus. [Online] PubMed. 2020.
Grantham‐McGregor S, Powell C, Walker S, et al. The long-term follow-up of severely malnourished children who participated in an intervention program. Child Dev 1994;65:428-39. DOI: https://doi.org/10.1111/j.1467-8624.1994.tb00761.x
Burns J, Shank C, Ganigara M, et al. Cardiac complications of malnutrition in adolescent patients: A narrative review of contemporary literature. Ann Pediatr Cardiol 2021;14:501–6. DOI: https://doi.org/10.4103/apc.apc_258_20
Das S, Rajesh Kumar Meena, Shah D, et al. Children with severe acute malnutrition have high rates of bone resorption: A cross-sectional comparative study. Nutr Res 2023;117:66–72. DOI: https://doi.org/10.1016/j.nutres.2023.06.007
Bourke CD, Berkley JA, Prendergast AJ. Immune Dysfunction as a Cause and Consequence of Malnutrition. Trends Immunol [Internet]. 2016;37:386–98. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4889773/ DOI: https://doi.org/10.1016/j.it.2016.04.003
Talbert A, Atkinson S, Karisa J, et al. Hypothermia in Children with Severe Malnutrition: Low Prevalence on the Tropical Coast of Kenya. J Trop Pediatr [Internet]. 2009 [cited 2022 Dec 15];55:413–6. Available from: https://academic.oup.com/tropej/article/55/6/413/1727600 DOI: https://doi.org/10.1093/tropej/fmp038
Corsello A, Chiara Maria Trovato, Dipasquale V, et al. Refeeding syndrome in pediatric age, an unknown disease: A narrative review. J Pediatr Gastroenterol Nutr 2023;77:e75–83. DOI: https://doi.org/10.1097/MPG.0000000000003945
Galler JR, Bringas-Vega ML, Tang Q, et al. Neurodevelopmental effects of childhood malnutrition: a neuroimaging perspective. Neuroimage 2021;231:117828. DOI: https://doi.org/10.1016/j.neuroimage.2021.117828
Soliman A, Sanctis V, Elalaily R. Nutrition and pubertal development. Indian J of Endocrinol Metab [Internet]. 2014;18:39. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4266867/ DOI: https://doi.org/10.4103/2230-8210.145073
Zubairu AI, Oladigbolu K, Samaila E, Elijah P. Ocular morbidity among children with protein energy malnutrition in Northwest Nigeria. J West Afr Coll Surg [Internet]. 2022 [cited 2023 Feb 6];12:83. Available from: https://www.jwacs-jcoac.com/temp/JWestAfrCollSurg12183-6008561_164125.pdf DOI: https://doi.org/10.4103/jwas.jwas_56_22
Mohamed Bar, Paediatric Trainee, Southend University Hospital, Mid and South Essex NHS Trust

Paediatric Trainee, Southend University Hospital, Mid and South Essex NHS Trust, UK

How to Cite

Reed, A., & Bar, M. (2024). Extreme nutritional neglect leading to cardiac arrest in a child: a rare presentation of severe acute malnutrition in England. Emergency Care Journal. https://doi.org/10.4081/ecj.2024.13186
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