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Published on: July 26, 2017
Factors impacting nutritional status in infants with single ventricle physiology
Mark Edward Gormley1, Emily Behling2, Rebecca Freese3
1https://ror.org/017zqws13University of Minnesota Medical School, Department of Pediatrics, Minneapolis, MN, USA.
Insights
Infants with single ventricle physiology face undernutrition risks. Early respiratory interventions may improve nutritional outcomes, as seen by declining undernutrition rates after 2013.
Area of Science:
- Pediatric Cardiology
- Neonatal Nutrition
- Congenital Heart Disease
Background:
- Infants with single ventricle physiology have high undernutrition risks, impacting outcomes.
- Undernutrition in this population is a significant clinical concern.
Purpose of the Study:
- To examine factors associated with undernutrition in infants with single ventricle physiology at one year of age.
- To identify trends and potential interventions for improving nutritional status.
Main Methods:
- Retrospective case series of 56 infants undergoing single ventricle palliation.
- Undernutrition defined as weight-for-length z-score < -1 (WHO data).
- Fisher's exact test used to assess associations with surgical, cardiorespiratory, and nutritional factors.
Main Results:
- 16% of infants were undernourished at one year.
- A significant decline in undernutrition rates was observed after 2013 (p=0.02).
- Supplemental oxygen or pulmonary medications showed a non-significant trend towards lower undernutrition rates.
Conclusions:
- Nutritional outcomes in infants with single ventricle physiology have improved over time.
- Early respiratory interventions may offer nutritional benefits.
- Further research is needed to confirm the impact of respiratory support on nutritional status.
Abstract:
Infants with single ventricle physiology are at increased risk of undernutrition, which can contribute to adverse outcomes. This is a retrospective case series examining factors associated with undernutrition in patients with single ventricle physiology at one year of age. It includes 56 infants from a single institution who underwent single ventricle palliation between 2003 and 2023. Undernutrition was defined as a weight-for-length z-score below -1, based on World Health Organization normative data. Independent variables included surgical interventions, cardiorespiratory factors, and nutritional interventions. Associations between these variables and nutritional status were assessed using Fisher's exact test. At one year, a total of nine infants (16%) were undernourished. Undernutrition rates significantly declined after 2013 (p = 0.02), demonstrating improvements in nutritional outcomes over our study period. Those who used supplemental oxygen or pulmonary medications were undernourished at lower rates, though this difference was not statistically significant. While the number of undernourished patients in the cohort may have limited the study's power, our findings suggest that early respiratory interventions may provide nutritional benefits in infants with single ventricle physiology.
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