Related Experiment Videos

Low energy intakes are associated with adverse outcomes in infants after open heart surgery

Bodil M K Larsen1, Laksiri A Goonewardene, Catherine J Field

  • 1Nutrition Services, University of Alberta, Edmonton, Alberta, Canada.

JPEN. Journal of Parenteral and Enteral Nutrition
|October 16, 2012
PubMed

Insights

Adequate energy intake is crucial for infants after open heart surgery. Insufficient nutrition (<63 kcal/kg/d) is linked to longer recovery times and increased complications in the pediatric intensive care unit.

Area of Science:

  • Pediatric Critical Care Medicine
  • Neonatal Surgery
  • Nutritional Support

Background:

  • Infants undergoing open heart surgery experience significant metabolic stress postoperatively.
  • This stress can lead to altered metabolism and hypercatabolism.
  • Understanding nutritional needs is vital for improving outcomes.

Purpose of the Study:

  • To investigate the association between energy intake and hospital outcomes in neonates after open heart surgery.
  • To determine the optimal energy threshold for recovery in the first 10 postoperative days.

Main Methods:

  • Post hoc analysis of a prospective randomized controlled trial involving 32 infants.
  • Assessment of nutrition intake and hospital outcomes in neonatal and pediatric intensive care units.
  • Comparison of outcomes between infants receiving <689 kcal (average 63 kcal/kg/d) and ≥689 kcal during postoperative days 0-10.

Main Results:

  • Lower energy intake (<63 kcal/kg/d) correlated with significantly longer mechanical ventilation duration (5 ± 1.2 days).
  • Reduced energy intake was associated with increased time to chest closure (1.4 ± 0.5 days) and longer intensive care unit stays (5 ± 1.8 days).
  • Infants with lower energy intake required longer parenteral nutrition support (8 ± 2.9 days) and experienced delays in achieving full enteral feeding.

Conclusions:

  • Energy intake below 63 kcal/kg/d in the early postoperative period is linked to adverse outcomes in infants after open heart surgery.
  • Optimal nutritional support is critical for mitigating complications and improving recovery trajectories.
  • Findings highlight the importance of monitoring and optimizing energy delivery in this vulnerable population.
Abstract

Related Concept Videos

Enteral Nutrition II: Nasointestinal and Gastrostomy Feeding01:15

Enteral Nutrition II: Nasointestinal and Gastrostomy Feeding

Enteral nutrition encompasses various methods of delivering nutrition directly to the gastrointestinal (GI) tract, bypassing traditional oral intake. It is particularly beneficial for patients who cannot eat by mouth but have a functioning digestive system. Key methods include nasointestinal feeding, gastrostomy, and jejunostomy, each suited to different clinical scenarios based on the patient's needs and condition.
Nasointestinal Feeding
Nasointestinal feeding involves placing a tube through...
Heart Failure VI: Adjunct Therapies01:22

Heart Failure VI: Adjunct Therapies

Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy

Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Enteral Nutrition I: Orogastric and Nasogastric Feeding01:26

Enteral Nutrition I: Orogastric and Nasogastric Feeding

Enteral nutrition delivers nutrients directly to the stomach or small intestine through a tube. This method is appropriate for patients who cannot eat but still have a functioning digestive system. It is also beneficial for individuals with swallowing difficulties, anorexia, malabsorption, or those who have undergone gastrointestinal (GI) surgery.
Orogastric (OG) and nasogastric (NG) feeding are two standard methods used for enteral nutrition. Enteral nutrition is often preferred over...
Cardiomyopathy VII: Pre and Post Operative Nursing Management01:28

Cardiomyopathy VII: Pre and Post Operative Nursing Management

Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
Intestinal Obstruction II: Pathophysiology01:07

Intestinal Obstruction II: Pathophysiology

Intestinal obstruction triggers a series of physiological responses, starting with gas and fluid accumulation in the bowel segment proximal to the obstruction, leading to distension. This distended intestine compresses the diaphragm, hindering lung expansion and potentially leading to reduced respiratory effort, atelectasis, and pneumonia.To overcome the blockage, the gut intensifies contractions, causing colicky abdominal pain, nausea, and vomiting, which reduces fluid and food intake and...