Preoperative Oral Feeding in Infants with Congenital Heart Disease Within the First Month of Life is Associated with a Higher Likelihood of Freedom From Tube Feeding at Time of Postoperative Discharge.

IF 1.5 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Aseel Dabbagh, Sarah Miller, Michael McCulloch, Geoffrey Rosenthal, Mark Conaway, Shelby White
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Abstract

Though several studies have demonstrated that preoperative oral feeding (PO) can be safe in patients with congenital heart disease, they are commonly prohibited from doing so, potentially precluding the development of such skills. We sought to determine whether preoperative oral feeding is associated with freedom from tube feeding at postoperative discharge. Single-center, observational study including patients in the first month of life (≤ 30 days of age) who underwent a single cardiac surgery between 7/1/2017-6/30/2022 and survived to discharge. Preoperative PO was defined as any oral intake up to the day of cardiac surgery. General demographics and peri-operative characteristics were analyzed. A total of 235 patients were included of which 178 (78%) PO fed preoperatively, and 171 (73%) were discharged taking full PO. Those discharged without tube feeds received more preoperative oral feeds, were less likely to have a chromosomal abnormality/genetic syndrome, had lower STAT categories, and were less likely to have postoperative complications, vocal cord dysfunction or prolonged mechanical ventilation. Multivariate analysis found that any preoperative PO [odds ratio (OR) of 2.78 (CI 1.48, 5.24, p-value = 0.002)] and increasing amounts of PO were predictive of full PO intake at discharge [≤ 20 ml/kg/day (OR 2.06, CI 1.03, 4.14, p-value = 0.042) and > 20 ml/kg/day (OR 4.07, CI 1.88, 8.84, p-value = 0.004)]. Preoperative oral feeding is a strong predictor of discharging with full PO intake after cardiac surgery in the first month of life and that it may also improve with increasing volumes. Multi-institutional analyses are warranted.

先天性心脏病婴儿在出生后第一个月内术前口服喂养与术后出院时免于管饲的可能性较高相关
虽然有几项研究表明,术前口服喂养(PO)对先天性心脏病患者是安全的,但他们通常被禁止这样做,这可能会阻碍这种技能的发展。我们试图确定术前口服喂养是否与术后出院时免于管饲有关。单中心观察性研究,包括在2017年7月1日至2022年6月30日期间接受单次心脏手术并存活至出院的出生后第一个月(≤30天)的患者。术前PO定义为心脏手术当天的任何口服摄入量。分析一般人口学特征和围手术期特征。共纳入235例患者,其中178例(78%)术前给予PO, 171例(73%)出院时给予全PO。无管饲的出院患者术前口服喂养较多,染色体异常/遗传综合征发生率较低,STAT分类较低,术后并发症、声带功能障碍或机械通气时间延长的发生率较低。多因素分析发现,术前PO[比值比(OR)为2.78 (CI 1.48, 5.24, p值= 0.002)]和PO量增加可预测出院时PO摄入量[≤20 ml/kg/day (OR 2.06, CI 1.03, 4.14, p值= 0.042)和bb0 20 ml/kg/day (OR 4.07, CI 1.88, 8.84, p值= 0.004)]。术前口服喂养是心脏手术后第一个月全PO摄入量出院的一个强有力的预测指标,并且随着容量的增加,它也可能改善。多机构分析是必要的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Pediatric Cardiology
Pediatric Cardiology 医学-小儿科
CiteScore
3.30
自引率
6.20%
发文量
258
审稿时长
12 months
期刊介绍: The editor of Pediatric Cardiology welcomes original manuscripts concerning all aspects of heart disease in infants, children, and adolescents, including embryology and anatomy, physiology and pharmacology, biochemistry, pathology, genetics, radiology, clinical aspects, investigative cardiology, electrophysiology and echocardiography, and cardiac surgery. Articles which may include original articles, review articles, letters to the editor etc., must be written in English and must be submitted solely to Pediatric Cardiology.
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