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Implantation of Total Artificial Heart in Congenital Heart Disease
Published on: July 18, 2014
Nutrition Support for Children Undergoing Congenital Heart Surgeries: A Narrative Review
Judith J M Wong1, Ira M Cheifetz2, Chengsi Ong3
1Department of Pediatric Medicine, KK Women's and Children's Hospital, Singapore.
Insights
Children with congenital heart disease (CHD) often experience energy imbalance, risking nutritional decline during surgery. Optimizing nutrition perioperatively is crucial for improving surgical outcomes in these vulnerable patients.
Area of Science:
- Pediatric Cardiology
- Pediatric Critical Care
- Nutritional Science
Background:
- Energy imbalance is prevalent in infants and children with congenital heart disease (CHD).
- Nutritional status can deteriorate during surgical hospitalizations due to physiological stress.
- Poor nutrition correlates with increased perioperative morbidity and mortality in pediatric CHD patients.
Purpose of the Study:
- To review energy expenditure and metabolism in critically ill children with CHD.
- To examine perioperative factors affecting energy metabolism.
- To assess bedside practices for optimizing nutrient delivery and the long-term impact of energy balance on outcomes.
Main Methods:
- This is a review examining existing literature on nutrition in pediatric CHD.
- The review synthesizes information on energy expenditure, metabolism, and nutritional interventions.
- A proposed nutrition algorithm for perioperative optimization is presented.
Main Results:
- Energy imbalance is influenced by age, cardiac diagnosis, and heart failure status.
- Surgical stress, anesthesia, and postoperative care significantly impact nutritional status.
- Optimizing nutrient delivery can potentially improve clinical outcomes.
Conclusions:
- Perioperative nutrition is a critical factor in managing children with CHD.
- Implementing a structured nutrition algorithm may enhance surgical outcomes.
- Further research into energy balance and its long-term effects is warranted.
Abstract:
Energy imbalance in infants and children with congenital heart disease (CHD) is common and influenced by age, underlying cardiac diagnoses, and presence or absence of congestive heart failure. During the surgical hospitalization period, these children are prone to nutritional deterioration due to stress of surgery, anesthetic/perfusion techniques, and postoperative care. Poor nutrition is associated with increased perioperative morbidity and mortality. This review aims to examine various aspects of nutrition in critically ill children with CHD, including (1) energy expenditure, (2) perioperative factors that contribute to energy metabolism, (3) bedside practices that are potentially able to optimize nutrient delivery, and (4) medium- to long-term impact of energy balance on clinical outcomes. We propose a nutrition algorithm to optimize nutrition of these children in the perioperative period where improvements in nutrition status will likely impact surgical outcomes.
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