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Early high-energy feeding in infants following cardiac surgery: a randomized controlled trial
Xi Chen1, Mingjie Zhang1, Yixiao Song1
1Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Insights
Early high-energy feeding in infants after congenital heart surgery improves growth and recovery. This intervention reduces intensive care unit stays, ventilator support, and infection rates, aiding nutritional recovery.
Area of Science:
- Pediatric Cardiology
- Neonatal Nutrition
- Surgical Recovery
Background:
- Effective nutrition programs are crucial for infant recovery.
- Limited research exists on early high-energy feeding post-congenital heart surgery.
- This study investigates the impact of early high-energy feeding in infants undergoing open heart surgery.
Purpose of the Study:
- To assess the effects of early high-energy feeding on infants following congenital heart surgery.
- To evaluate impacts on growth parameters and recovery metrics.
- To determine the safety and efficacy of this nutritional strategy.
Main Methods:
- A randomized controlled trial involving 244 infants undergoing open heart surgery.
- Intervention group received early high-energy feeding; control group received standard care.
- Primary endpoints included energy delivery and growth Z-scores (WHZ, WAZ, HAZ); secondary endpoints included malnutrition recovery, ventilator support, infection rate, and CICU stay.
Main Results:
- The intervention group showed significantly higher average calorie intake (44.5 vs. 34.7 kcal/day).
- Improved weight-for-height Z-score (WHZ) and weight-for-age Z-score (WAZ) were observed at ICU discharge in the intervention group.
- Reduced ventilator support time, CICU stay, and infection rates were noted in the intervention group, along with a higher malnutrition recovery rate at 3 months (19.4% vs. 6.5%).
Conclusions:
- Early high-energy feeding post-congenital heart surgery enhances infant growth.
- This nutritional approach significantly reduces critical care duration and infection risk.
- The findings support the implementation of early high-energy feeding for improved outcomes in pediatric cardiac surgery patients.
Background:
Effective nutrition programs are beneficial for nutritional recovery in infants. Few studies have focused on the effect of early high-energy feeding after open heart surgery. This study sought to assess the effects of early high-energy feeding in infants after congenital heart surgery.
Methods:
Patients at a tertiary pediatric cardiology center who underwent open heart surgery between July 2016 and July 2018 were recruited and randomly allocated to 1 of the following 2 groups: (I) the intervention group (postoperative early high-energy feeding; n=124); and (II) the control group (no intervention; n=120).The primary endpoints of average energy delivery and growth Z-scores [i.e., weight-for-height Z-score (WHZ), weight-for-age Z-score (WAZ), and height-for-age Z-score (HAZ)] were recorded preoperatively, during the intensive care unit (ICU) stay, at discharge, and at 1 and 3 months postoperatively. The secondary endpoints of malnutrition recovery, ventilator support time, infection rate, and cardiac ICU (CICU) stay were also recorded.
Results:
A total of 244 infants were included in the study. There were no significant differences in the baseline features between the 2 groups. The intervention group received higher calories on average than the control group (44.5 vs. 34.7; P<0.001). At discharge from the ICU, the WHZ (-2.29 vs. -2.76; P<0.001) and WAZ (-3.08 vs. -3.43; P=0.005) of patients in the intervention group were higher than those of patients in the control group. Ventilator support time (P=0.004), CICU stay (P=0.045), and infection rate (P=0.001) were significantly lower in the intervention group than the control group. At 3 months post-surgery, the intervention group exhibited a higher malnutrition recovery rate than the control group (19.4% vs. 6.5%; P=0.002).
Conclusions:
The administration of early high-energy feeding to infants after congenital heart surgery is associated with improved growth, reduced CICU stay, decreased ventilator support time, and reduced postoperative infection rates.
Trial Registration:
ClinicalTrials NCT04609358.
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