The Relationship Between Preoperative Feeding Exposures and Postoperative Outcomes in Infants With Congenital Heart Disease.
Journal
Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
ISSN: 1529-7535
Titre abrégé: Pediatr Crit Care Med
Pays: United States
ID NLM: 100954653
Informations de publication
Date de publication:
01 01 2021
01 01 2021
Historique:
pubmed:
4
10
2020
medline:
22
4
2021
entrez:
3
10
2020
Statut:
ppublish
Résumé
To evaluate the association of preoperative risk factors and postoperative outcomes in infants with complex congenital heart disease. Single-center retrospective cohort study. Neonatal ICU and cardiovascular ICU. Infants of all gestational ages, born at Texas Children's Hospital between 2010 and 2016, with complex congenital heart disease requiring intervention prior to discharge. None. A total of 399 patients were enrolled in the study. Preoperative risk factors included feeding, type of feeding, feeding route, and cardiac lesion. Postoperative outcomes included necrotizing enterocolitis, hospital length of stay, and days to full feeds. The occurrence rate of postoperative necrotizing enterocolitis (all stages) was 8%. Preoperative feeding, type of feeding, feeding route, and cardiac lesion were not associated with higher odds of postoperative necrotizing enterocolitis. Cardiac lesions with ductal-dependent systemic blood flow were associated with a hospital length of stay of 19.6 days longer than those with ductal-dependent pulmonary blood flow (p < 0.001) and 2.9 days longer to reach full feeds than those with ductal-dependent pulmonary blood flow (p < 0.001), after controlling for prematurity. Nasogastric feeding route preoperatively was associated with a length of stay of 29.8 days longer than those fed by mouth (p < 0.001) and 2.4 days longer to achieve full feeds (p < 0.001), after controlling for prematurity and cardiac lesion. Preoperative diet itself was not associated with significant change in length of stay or days to reach full feeds. Although cardiac lesions with ductal-dependent systemic blood flow are considered high risk and may increase length of stay and days to achieve full feeds, they are not associated with a higher risk of postoperative necrotizing enterocolitis. Nasogastric route is not associated with a significantly higher risk of necrotizing enterocolitis, but longer length of stay and days to reach full feeds. These findings challenge our perioperative management strategies in caring for these infants, as they may incur more hospital costs and resources without significant medical benefit.
Identifiants
pubmed: 33009358
pii: 00130478-202101000-00026
doi: 10.1097/PCC.0000000000002540
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e91-e98Informations de copyright
Copyright © 2020 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.
Déclaration de conflit d'intérêts
Dr. Kataria-Hale’s institution received funding from the Evie Whitlock Foundation. Dr. Hair’s institution received funding from Prolacta Bioscience and Fresenius Kabi. The remaining authors have disclosed that they do not have any potential conflicts of interest.
Références
Giannone PJ, Luce WA, Nankervis CA, et al. Necrotizing enterocolitis in neonates with congenital heart disease. Life Sci. 2008; 82:341–347
Hebra A, Brown MF, Hirschl RB, et al. Mesenteric ischemia in hypoplastic left heart syndrome. J Pediatr Surg. 1993; 28:606–611
Young CM, Kingma SD, Neu J. Ischemia-reperfusion and neonatal intestinal injury. J Pediatr. 2011; 158:e25–e28
Harrison AM, Davis S, Reid JR, et al. Neonates with hypoplastic left heart syndrome have ultrasound evidence of abnormal superior mesenteric artery blood flow before and after modified Norwood procedure. Pediatr Crit Care Med. 2005; 6:445–447
Natarajan G, Reddy Anne S, Aggarwal S. Enteral feeding of neonates with congenital heart disease. Neonatology. 2010; 98:330–336
Becker KC, Hornik CP, Cotten CM, et al. Necrotizing enterocolitis in infants with ductal-dependent congenital heart disease. Am J Perinatol. 2015; 32:633–638
Toms R, Jackson KW, Dabal RJ, et al. Preoperative trophic feeds in neonates with hypoplastic left heart syndrome. Congenit Heart Dis. 2015; 10:36–42
Day TG, Dionisio D, Zannino D, et al. Enteral feeding in duct-dependent congenital heart disease. J Neonatal Perinatal Med. 2019; 12:9–12
Hair AB, Peluso AM, Hawthorne KM, et al. Beyond necrotizing enterocolitis prevention: Improving outcomes with an exclusive human milk-based diet. Breastfeed Med. 2016; 11:70–74
Cortez J, Makker K, Kraemer DF, et al. Maternal milk feedings reduce sepsis, necrotizing enterocolitis and improve outcomes of premature infants. J Perinatol. 2018; 38:71–74
Howley LW, Kaufman J, Wymore E, et al. Enteral feeding in neonates with prostaglandin-dependent congenital cardiac disease: International survey on current trends and variations in practice. Cardiol Young. 2012; 22:121–127
Indramohan G, Pedigo TP, Rostoker N, et al. Identification of risk factors for poor feeding in infants with congenital heart disease and a novel approach to improve oral feeding. J Pediatr Nurs. 2017; 35:149–154
Holst LM, Serrano F, Shekerdemian L, et al. Impact of feeding mode on neurodevelopmental outcome in infants and children with congenital heart disease. Congenit Heart Dis. 2019; 14:1207–1213
Neu J. Gastrointestinal development and meeting the nutritional needs of premature infants. Am J Clin Nutr. 2007; 85:629S–634S
Cognata A, Kataria-Hale J, Griffiths P, et al. Human milk use in the preoperative period is associated with a lower risk for necrotizing enterocolitis in neonates with complex congenital heart disease. J Pediatr. 2019; 215:11–16.e2
Lau PE, Cruz SM, Ocampo EC, et al. Necrotizing enterocolitis in patients with congenital heart disease: A single center experience. J Pediatr Surg. 2018; 53:914–917
McElhinney DB, Hedrick HL, Bush DM, et al. Necrotizing enterocolitis in neonates with congenital heart disease: Risk factors and outcomes. Pediatrics. 2000; 106:1080–1087
Petrillo-Albarano T, Pettignano R, Asfaw M, et al. Use of a feeding protocol to improve nutritional support through early, aggressive, enteral nutrition in the pediatric intensive care unit. Pediatr Crit Care Med. 2006; 7:340–344
Barr J, Hecht M, Flavin KE, et al. Outcomes in critically ill patients before and after the implementation of an evidence-based nutritional management protocol. Chest. 2004; 125:1446–1457
del Castillo SL, McCulley ME, Khemani RG, et al. Reducing the incidence of necrotizing enterocolitis in neonates with hypoplastic left heart syndrome with the introduction of an enteral feed protocol. Pediatr Crit Care Med. 2010; 11:373–377
Gephart SM, Hanson CK. Preventing necrotizing enterocolitis with standardized feeding protocols: Not only possible, but imperative. Adv Neonatal Care. 2013; 13:48–54
Kasiraj AC, Harmoinen J, Isaiah A, et al. The effects of feeding and withholding food on the canine small intestinal microbiota. FEMS Microbiol Ecol. 2016; 92:fiw085
Gregory KE, Samuel BS, Houghteling P, et al. Influence of maternal breast milk ingestion on acquisition of the intestinal microbiome in preterm infants. Microbiome. 2016; 4:68
Butler SC, Sadhwani A, Stopp C, et al. Neurodevelopmental assessment of infants with congenital heart disease in the early postoperative period. Congenit Heart Dis. 2019; 14:236–245
Greene Z, O’Donnell CP, Walshe M. Oral stimulation for promoting oral feeding in preterm infants. Cochrane Database Syst Rev. 2016; 9:CD009720
Li XL, Liu Y, Liu M, et al. Early premature infant oral motor intervention improved oral feeding and prognosis by promoting neurodevelopment. Am J Perinatol. 2020; 37:626–632
Ghomi H, Yadegari F, Soleimani F, et al. The effects of premature infant oral motor intervention (PIOMI) on oral feeding of preterm infants: A randomized clinical trial. Int J Pediatr Otorhinolaryngol. 2019; 120:202–209
Song D, Jegatheesan P, Nafday S, et al. Patterned frequency-modulated oral stimulation in preterm infants: A multicenter randomized controlled trial. PLoS One. 2019; 14:e0212675
Medoff-Cooper B, Irving SY, Hanlon AL, et al. The association among feeding mode, growth, and developmental outcomes in infants with complex congenital heart disease at 6 and 12 months of age. J Pediatr. 2016; 169:154–159.e1