Factors that Influence Placement of Gastrostomy Tube in Infants with Complex Congenital Heart Disease: A Single...

Area of Science:

• Pediatric Cardiology
• Neonatal Surgery
• Congenital Heart Defects

Background:

• Infants with complex congenital heart defects (CHD) often require specialized feeding support.
• Predicting the need for gastrostomy tube (G-tube) placement in these infants is challenging for expectant parents.
• Identifying key factors can improve prenatal counseling and postnatal management strategies.

Purpose of the Study:

• To identify clinical factors associated with gastrostomy tube (G-tube) placement in infants diagnosed prenatally with complex congenital heart defects (CHD).
• To provide data that can enhance counseling for expectant parents regarding potential postnatal outcomes and interventions.
• To understand the relationship between feeding milestones, ventilation support, and G-tube necessity.

Main Methods:

• Retrospective review of medical records for infants with complex CHD.
• Study period: 2015-2019 at a single tertiary care center.
• Linear regression analysis used to assess risk factors for G-tube placement.

Main Results:

• 42% (44 of 105) of infants with complex CHD required G-tube placement.
• Significant predictors for G-tube placement included: increased days on non-invasive ventilation, delayed initiation of gavage-tube feeds, delayed achievement of full-volume gavage feeds, and longer intensive care unit (ICU) length of stay (LOS).
• Infants with ICU LOS exceeding the median had a 7.23-fold increased odds of requiring a G-tube.

Conclusions:

• Delayed initiation and progression of gavage-tube feeding post-cardiac surgery are significant predictors for G-tube placement.
• Increased duration of non-invasive ventilation and ICU stay are strongly associated with the need for G-tubes.
• The specific type of CHD or the necessity of cardiac surgery itself did not emerge as significant predictors for G-tube placement in this cohort.