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Predictors of oral feeding difficulty in cardiac surgical infants
Kathleen D Einarson1, Heather M Arthur
1Cardiovascular Surgery, The Hospital for Sick Children, Toronto, Ontario.
Insights
Postoperative feeding difficulties in neonates after cardiac surgery are linked to vocal cord injury, prolonged intubation, and lower weight at surgery. Identifying these risk factors can improve infant care.
Area of Science:
- Pediatric Surgery
- Neonatal Care
- Clinical Outcomes Research
Background:
- Feeding difficulties are a significant concern for neonates undergoing cardiac surgery.
- Understanding predictors of these challenges is crucial for optimizing patient recovery and care.
Purpose of the Study:
- To identify key factors associated with postoperative feeding difficulties in neonates following cardiac surgery.
- To analyze potential predictors including diagnosis, demographics, surgical details, and postoperative course.
Main Methods:
- Retrospective cohort study involving chart audit of 101 neonates who underwent cardiac surgery.
- Analysis of ten variables to determine independent predictors of oral feeding success at discharge.
Main Results:
- 71.3% of infants achieved oral feeding by hospital discharge.
- Vocal cord injury (OR 11.80), prolonged intubation (OR 1.10 per day), and lower weight at surgery (OR 0.34) were independent predictors of feeding failure.
- Mean hospital length of stay was 17.73 days.
Conclusions:
- Vocal cord injury, prolonged intubation, and low weight at surgery are significant risk factors for feeding difficulties in neonates post-cardiac surgery.
- Early identification of at-risk infants can inform targeted interventions.
- Developing strategies to mitigate these risks may reduce morbidity and improve resource utilization.
Purpose:
The purpose of this study was to identify factors contributing to postoperative feeding difficulties in neonates following cardiac surgery.
Methods:
A retrospective cohort study used chart audit of 101 consecutive infants who underwent cardiac surgery. Ten variables were analyzed as possible predictors of postoperative feeding difficulties including: diagnosis, demographics, details of surgery, and postoperative course.
Results:
At hospital discharge, 72 (71.3%) infants were orally feeding and 29 (28.7%) were not. Overall mean hospital length of stay was 17.73 (+ 16.40 days). Multivariate logistic regression analysis revealed vocal chord injury (odds ratio 11.80), length of postoperative intubation (odds ratio 1.10 per day), and weight at surgery (odds ratio 0.34) as independent predictors of failure to feed orally at discharge from hospital.
Conclusion:
Risk factors for feeding difficulties in the postcardiac surgery infant are vocal chord injury, prolonged intubation, and low weight at surgery. Early identification of neonates at risk for feeding difficulties may lead to development of strategies to reduce morbidity, improve patient care, and provide better resource utilization.