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Predictors of the inability to achieve full oral feeding in postoperative infants with CHD

Marin Jacobwitz1,2, Sharon Y Irving3,4, Helene Moriarty2

  • 1Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.

Cardiology in the Young
|August 23, 2023
PubMed

Insights

Longer deep hypothermic circulatory arrest and reintubation predict poor oral feeding in neonates with complex congenital heart disease (CHD). Earlier discharge may be beneficial, as prolonged hospitalization for feeding is of limited utility after postoperative day 10.

Area of Science:

  • Neonatal surgery
  • Pediatric cardiology
  • Clinical outcomes

Background:

  • Poor oral feeding impacts growth in neonates with complex congenital heart disease (CHD) requiring surgery.
  • Approximately 60% of these infants do not achieve full oral feeding before hospital discharge.
  • Early surgical intervention is often necessary for complex CHD.

Purpose of the Study:

  • Identify predictors of inability to achieve full oral feeding by discharge in neonates with complex CHD.
  • Analyze factors influencing oral feeding status post-cardiopulmonary bypass surgery.
  • Determine the utility of prolonged hospitalization for feeding in neonates with CHD.

Main Methods:

  • Retrospective analysis of a prospective study involving 192 full-term neonates with complex CHD.
  • Development of a stepwise logistic regression model to predict oral feeding status at discharge.
  • Univariate subgroup analysis based on a CHD classification system.

Main Results:

  • 58% of neonates failed to achieve full oral feeding by hospital discharge.
  • Duration of deep hypothermic circulatory arrest and reintubation were significant predictors of inability to achieve full oral feeding.
  • Brain maturation, brain injury, and preoperative oral feeding were not predictive of postoperative oral feeding success.

Conclusions:

  • Many infants with CHD struggle with full oral feeding post-surgery.
  • Extended deep hypothermic circulatory arrest and increased intubations are linked to poor feeding outcomes.
  • Discharging neonates earlier, rather than prolonging hospitalization solely for feeding after postoperative day 10, may prevent negative neurodevelopmental consequences.
Abstract

Keywords:
CHDneonatalneonatal cardiac surgeryoral feeding dysfunction

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