Analysis of Autonomic, Respiratory and Motor Function of Infants in Pre- and Post-Liver Transplantation

Denise De Souza Rolim,Andrea De Oliveira Franco Queiroga,Juliana Angi Roche,Luciana Maria Malosá Sampaio,Évelim Leal De Freitas Dantas Gomes,Audrey Borghi-Silva

doi:10.4236/ijcm.2014.521176

Abstract

Purpose: Children with liver impairment are likely to develop changes in autonomic nervous function and delay in motor development. The assessment and identification of these dysfunctions may allow an appropriate physiotherapeutic care. Method: Cross sectional study of 18 infants, 11 controls and 7 infants (post-liver transplantation) with an average age of 10 ± 4.5 months, was evaluated in pre- and post-liver transplant. All infants underwent to assessments of motor skills, body composition, chest and abdominal motion, and cardiac autonomic modulation was measured by heart rate variability. Results: Motor delay and malnutrition were found in all infants. The gravity index (PELD)—pediatric end-stage liver disease—showed a negative correlation with the Alberta Infant Motor Scale (r = 0.83, p = 0.01). In addition, reduced parasympathetic modulation was demonstrated by the rMSSD, SD1 and ApEn, pre- and post-transplant. Conclusion: Infants with liver disease, even after transplantation, have delay in motor development, as well as changes in their nutritional and autonomic dysfunction.

Highlights

The liver has an important role in the maintenance of blood glucose, through gluconeogenesis and glycogen sto-How to cite this paper: de Souza Rolim, D., et al (2014) Analysis of Autonomic, Respiratory and Motor Function of Infants in Pre- and Post-Liver Transplantation
When liver disease is present as a result of changing these functions, there is a development of protein-calorie malnutrition
The same child who used pre-operative non-invasive mechanical ventilation (NIMV) stood at invasive mechanical ventilation (IMV) for 30 hours and was the only one that made use of post-operative NIMV

Summary

Introduction

The liver has an important role in the maintenance of blood glucose, through gluconeogenesis and glycogen sto-. How to cite this paper: de Souza Rolim, D., et al (2014) Analysis of Autonomic, Respiratory and Motor Function of Infants in Pre- and Post-Liver Transplantation. International Journal of Clinical Medicine, 5, 1384-1391. It acts in fat metabolism through fast oxidation of fatty acids for energy and formation of most lipoproteins. The liver plays a vital role in the formation of plasma proteins and urea, and deamination of amino acid [1]. When liver disease is present as a result of changing these functions, there is a development of protein-calorie malnutrition. There is loss of muscle mass and subcutaneous tissue [2]-[4]

Methods

Results

Conclusion