Nutrition support in neonates with congenital heart disease during the perioperative period / 肠外与肠内营养

ABSTRACT

Objective:To investigate the impact of hospital-based nutritional practices on weight gain in neonates during the immediate postoperative period.Methods:It is a retrospective study of 45 neonates who underwent modified systemic-to-pulmonary artery shunt in Huai'an First People's Hospital.We reviewed the weight-for-age Z-score (WAZ score) at the time points of the date of surgery,transfer from cardiac intensive care unit (CICU) to general ward,and day of hospital discharge.Caloric intake (calories/kg/day) and total fluid intake (ml/kg/day) at different time points were measured too.We also reviewed the initiation time of enteral feeding and CICU stay (days) postoperatively.Results:An overall median WAZ score decrease of-1.3 (IQR-1.7 to-0.7) from time of shunt palliation to hospital discharge.A length of stay of ＞5 days in the CICU,initiation of enteral feeding beyond the postoperative days (POD) 5 and the severity of diseases were significantly associated with a great mean difference in WAZ score(P ＜ 0.001,P ＜ 0.001,P =0.003).Conclusion:The nutrition support in immediate postoperative period is substantially lower than what is needed;initiation time of enteral feeding,a length of stay ＞ 5 days in the CICU and the severity of diseases were independent predictors of a greater change in WAZ score.