Related Experiment Video
Updated: Feb 1, 2026
Author Spotlight: Advancements and Challenges in Surgical Treatments for Postamputation Pain
Published on: March 8, 2024
High-energy nutrition in paediatric cardiac critical care patients: a randomized controlled trial
Huiwen Zhang1, Ying Gu2, YaPing Mi1
1Cardiac Intensive Care Unit, Children's Hospital of Fudan University, Shanghai, People's Republic of China.
Insights
High-energy formula in infants after cardiac surgery improved weight gain but increased feeding intolerance. Symptoms were manageable and did not impede feeding advancement, suggesting careful consideration for its use.
Area of Science:
- Pediatric critical care medicine
- Neonatal nutrition
- Pediatric cardiology
Background:
- Infants undergoing cardiac surgery often experience challenges with nutritional support.
- High-energy formula (HF) has shown potential for increased energy intake post-surgery with fewer cardiopulmonary side effects.
- The impact of HF on infant weight gain and gastrointestinal function post-cardiac surgery requires further investigation.
Purpose of the Study:
- To compare the effects of high-energy formula (HF) versus standard formula on weight gain in infants post-cardiac surgery.
- To evaluate the gastrointestinal tolerance of HF compared to standard formula in this patient population.
Main Methods:
- A randomized controlled trial was conducted in a pediatric cardiac intensive care unit.
- Infants (<1 year) received either HF (100 kcal/100 mL) or standard formula (67 kcal/100 mL) for 7 days post-surgery.
- Primary outcomes included weight gain and gastrointestinal intolerance; secondary outcomes were energy intake and clinical characteristics.
Main Results:
- Infants receiving HF experienced significantly less weight loss (-16 g) compared to the standard formula group (-181 g) (P=0.001).
- The HF group showed increased instances of gastrointestinal intolerance, including abdominal distension, gastric retention, and diarrhea, though these were manageable.
- Enteral energy intake was higher in the HF group from postoperative day three.
Conclusions:
- High-energy formula promotes better weight gain in infants following cardiac surgery.
- While HF can increase feeding intolerance, these symptoms are often manageable with medication and do not necessarily halt feeding progression.
- Clinicians should consider a gradual increase in formula energy density and monitor for feeding intolerance in malnourished infants post-cardiac surgery.
Background:
Previous studies have shown that feeding a high-energy formula (HF) to infants after cardiac surgery increases energy intake, with fewer side effects on cardiopulmonary function. However, impacts on weight gain and gastrointestinal function remain unclear.
Aims And Objectives:
To determine the impact of HF compared with standard formula on weight gain and gastrointestinal tolerance in postoperative infants with congenital heart disease.
Design:
This was a randomized controlled trial.
Methods:
The setting of the study was at a 20-bed cardiac intensive care unit at a tertiary children's hospital in China. Study population included infants <1 year of age who underwent cardiac surgery and were allocated to the intervention group (n = 32) or control group (n = 32). The intervention group received HF (100 kcal/100 mL), and the control group received standard formula (67 kcal/100 mL) for 7 days during the stabilized postoperative period at the cardiac intensive care unit. Primary outcomes were weight gain and gastrointestinal intolerance. Secondary outcomes were energy intake and standard intensive care characteristics.
Results:
Infants who received HF (n = 30) showed less weight loss than those who received standard formula (n = 29); -16 g [95% confidence interval (CI): -74 to 42] versus -181 g (95% CI: -264 to -99), P = 0·001. The evaluation of gastrointestinal intolerance showed that the intervention group had several side effects, such as abdominal distension (n = 1), gastric retention (n = 2) and diarrhoea (n = 1), while the control group had no problems. Enteral energy intake in the intervention group was higher than the control group from day three.
Conclusion:
Infants after cardiac surgery fed with HF gained more weight but had increased feeding intolerance. However, the feeding intolerance symptoms could be relieved by medication and did not affect feeding advancement.
Relevance To Clinical Practice:
Paediatric intensive care clinicians should consider gradually increasing the energy density of the formula during feeding and assess feeding intolerance signs in some children with malnutrition after cardiac surgery.
More Related Videos
Related Concept Videos
01:13Patient-centered Care
02:11The Roles of Bacteria and Fungi in Plant Nutrition
01:14Conservation of Energy in Control Volume
For steady flow systems, the time derivative of the stored energy becomes zero since there is no energy accumulation within the control volume. This simplifies the energy equation to:
01:27Parentral Nutrition: Centeral and Peripheral Parental Nutrition
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
01:11Clinical Trials: Overview
01:12Trial and Error and Algorithm