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Impact of Perioperative Brain Injury and Development on Feeding Modality in Infants With Single Ventricle Heart

Anyir Hsieh1, Sarah Tabbutt2, Duan Xu3

  • 11 Division of Cardiology Department of Pediatrics University of California San Francisco CA.

Journal of the American Heart Association
|May 10, 2019
PubMed

Insights

Slower brain maturation, not brain injury, is linked to tube feeding in infants with single-ventricle physiology (SVP). Optimizing brain health is key for improving feeding outcomes in these vulnerable infants.

Area of Science:

  • Pediatric Cardiology
  • Neonatal Neurology
  • Neurodevelopmental Pediatrics

Background:

  • Infants with single-ventricle physiology (SVP) often require tube-assisted feeding.
  • Delayed brain development and injury are prevalent in SVP patients, but their impact on feeding is unclear.

Purpose of the Study:

  • To investigate the association between neonatal brain injury and maturation with feeding tube dependency in SVP infants.

Main Methods:

  • A cohort of 48 term neonates with SVP underwent pre- and postoperative brain MRI.
  • Diffusion tensor imaging (DTI) assessed perioperative brain injury and microstructural development (fractional anisotropy and apparent diffusion coefficient).

Main Results:

  • 79% of infants were tube-fed at discharge, and 27% before stage-2 palliation.
  • Perioperative brain injury did not differ between feeding groups.
  • Orally fed infants showed more robust brain development, indicated by faster ADC decrease and FA increase.

Conclusions:

  • Slower postnatal brain maturation, not perioperative brain injury, correlates with feeding modality in infancy.
  • Brain health is crucial for optimizing feeding outcomes in single-ventricle physiology patients.

Keywords:
brain developmentbrain injuryfeedingsingle‐ventricle physiology

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