Nutrition-related risk factors for prolonged pleural effusion after congenital heart surgery in Chinese infants.

Background and objectives: Previous studies on the risk factors for prolonged pleural effusion (PPE) have primarily focused on surgical-related risk factors, with little research exploring the influence of nutritional factors on this delay. This study aimed to identify the nutritional risk factors for PPE in Chinese infants following congenital heart disease (CHD) surgery.

Methods and study design: We retrospectively reviewed the medical records of patients under 3 years old with chylothorax following CHD surgery from 2016 to 2020. PPE was defined as pleural effusion lasting over 14 days. Logistical regression analysis was conducted to identify the risk factors.

Results: Of 136 patients, 42 patients developed PPE (30.9%). The PPE group had lower Height-for-Age Z-scores (HAZ) compared to the non-PPE group, while other demographic factors were not significantly different. Univariate analysis revealed that patients in PPE group exhibited delayed onset of chylothorax, prolonged duration of mechanical ventilation, increased chest effusion volume on the first postoperative day, and a reduced proportion of energy intake from enteral nutrition (EN) during the stable phase. Variables with p-value of <0.1 in univariate logistic regression analysis were included in the multivariate logistic regression analysis. A delayed onset of chylothorax, extended periods of mechanical ventilation, a lower HAZ and a reduced proportion of energy intake from EN during the recovery phase.

Conclusions: A delayed onset of chylothorax, extended periods of mechanical ventilation, a lower HAZ, and a reduced proportion of energy intake from EN during the recovery phase predict a higher risk of PPE.