Standardized Feeding Approach Mitigates Weight Loss in Infants with Congenital Heart Disease.
Author ORCiD Identifier
The Journal of pediatrics
OBJECTIVE: To evaluate the effect of a standardized feeding approach using a clinical nutrition pathway on weight-for-age Z score (WAZ) over hospital length of stay (HLOS) for infants with congenital heart disease (CHD).
STUDY DESIGN: A ten-year retrospective cohort study examined eligible infants who underwent neonatal cardiac surgery between July 2009 through December 2018 (n=987). Eligibility criteria included infants born at least 37 weeks gestation and a minimum birth weight of 2 kilograms who underwent cardiac surgery for CHD within the first 30 days of life. Using the best linear unbiased predictions (BLUP) from a linear mixed effects model, WAZ change over HLOS was estimated before and after January 2013, when the standardized feeding approach was initiated. BLUP model included adjustment for patient characteristics including sex, race, HLOS, and class of cardiac defect.
RESULTS: Change in WAZ over HLOS was significantly higher during the period 2013-2018 than during the period 2009-2012 (β(SE)=0.16 (0.02), P < .001), after controlling for sex, race, HLOS, and CHD category, indicating that infants experienced decreased WAZ loss over HLOS after the standardized feeding approach was initiated. Additionally, differences were found in WAZ loss over HLOS between infants with single ventricle CHD (β(SE)=0.26 (0.04), p
CONCLUSIONS: These data suggest that an organized, focused approach for nutrition therapy using a standardized pathway improves weight change outcomes prior to hospital discharge for infants with single and two ventricle CHD who require neonatal cardiac surgery.
Lisanti, A., Savoca, M., Gaynor, J., Mascarenhas, M., Ravishankar, C., Sullivan, E., Pieciak, K., Costarino, A., Chen, J., Kennedy, A., Olsen, R., Min, J., Mondal, A., Huang, J., & Irving, S. Y. (2020). Standardized Feeding Approach Mitigates Weight Loss in Infants with Congenital Heart Disease.. The Journal of pediatrics https://doi.org/10.1016/j.jpeds.2020.12.047