Preoperative Nutrition-Based Interventions in Children Undergoing Cardiac Surgeries-A Systematic Review and...

Area of Science:

• Pediatric Surgery
• Nutritional Science
• Critical Care Medicine

Background:

• Pediatric cardiac surgery requires optimal patient condition for improved outcomes.
• Preoperative nutritional status significantly impacts recovery and complication rates in pediatric surgical patients.
• Evidence on the efficacy of preoperative nutrition interventions in this population is limited.

Purpose of the Study:

• To systematically review the efficacy and safety of preoperative nutrition-based interventions.
• To evaluate the impact of these interventions on pre-, intra-, and postoperative outcomes in children undergoing cardiac surgery.
• To assess the certainty of evidence using the GRADE approach.

Main Methods:

• Systematic search of CENTRAL, MEDLINE, and EMBASE databases up to July 2025.
• Inclusion of interventional and observational studies comparing nutritional interventions with control groups in pediatric cardiac surgery patients.
• Primary outcome: postoperative length of stay in the intensive care unit (ICU).

Main Results:

• Nineteen studies (8 RCTs, 1 non-randomized trial, 10 observational) evaluated diverse interventions like fatty acids and vitamin D.
• Two RCTs showed shorter ICU and hospital stays with extended preoperative nutritional support.
• Observational data suggested reduced hospital length of stay and faster enteral feeding, but no significant difference in ICU stay.

Conclusions:

• Preoperative nutrition interventions in pediatric cardiac surgery are safe with potential clinical benefits.
• The evidence supporting these benefits is of very low certainty.
• Significant heterogeneity necessitates well-designed trials and standardized preoperative nutritional protocols.