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Nutrition Support After Cardiac Surgery: Lessons Learned From a Prospective Study.
Chin Siang Ong1, Pooja Yesantharao1, Patricia M Brown1
1Division of Cardiac Surgery, Johns Hopkins Hospital, Baltimore, Maryland.
Seminars in Thoracic and Cardiovascular Surgery
|July 2, 2020
Summary
Postoperative nutrition support (NS) in cardiac surgery patients is crucial. While enteral feeding met two-thirds of needs, parenteral nutrition supplementation significantly improved calorie delivery and outcomes.
Area of Science:
- Cardiology
- Critical Care Medicine
- Nutritional Science
Background:
- Postoperative nutrition support (NS) is underrecognized in cardiac surgery.
- Patients requiring NS often have complex nutritional needs and higher morbidity.
Purpose of the Study:
- To describe NS delivery in cardiac surgery patients.
- To identify factors affecting calorie/protein delivery.
- To assess NS-associated morbidity.
Main Methods:
- Prospective observation of 2603 cardiac surgery patients from Jan 2015-Jan 2017.
- Analysis of NS indications, delivery (enteral/parenteral), and complications.
- Comparison of outcomes between patients with and without NS.
Main Results:
- 9% of patients required NS; 28% experienced diarrhea.
- Enteral feeding met 69% of caloric needs, improved to 86% with PN supplementation.
- Holding tube feeds for procedures significantly reduced delivery (43% vs 96%).
Conclusions:
- NS is vital for select cardiac surgery patients, with PN supplementation enhancing delivery.
- Diarrhea is a common complication linked to formula type and feeding route.
- Patients receiving NS had higher mortality and morbidity than those fed orally.
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