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Gastro-intestinal complications following neonatal cardiac catheterisation
D G Sweet1, B Craig, H L Halliday
1Royal Maternity Hospital, Belfast, Northern Ireland. dsweet@dnet.co.uk
Insights
Infants with congenital cyanotic heart disease undergoing cardiac catheterisation face a higher risk of necrotising enterocolitis (NEC). A cautious feeding approach post-procedure is recommended to mitigate these gastrointestinal complications.
Area of Science:
- Pediatric Cardiology
- Neonatal Gastroenterology
- Congenital Heart Disease
Background:
- Infants with congenital cyanotic heart disease (CCHD) have an elevated risk of necrotising enterocolitis (NEC).
- Cardiac catheterisation is a common procedure in managing CCHD.
Purpose of the Study:
- To investigate the potential role of cardiac catheterisation in the development of NEC among infants with CCHD.
Main Methods:
- A retrospective study of 65 infants with CCHD.
- Comparison of gastrointestinal complication incidence between infants who underwent cardiac catheterisation and those who did not.
Main Results:
- 11 catheterised infants developed bloody stools vs. 4 non-catheterised (OR 2.34).
- 5 catheterised infants developed NEC vs. 0 non-catheterised (OR 4.24).
- Four NEC cases occurred during re-feeding after catheterisation.
Conclusions:
- Cardiac catheterisation may increase the risk of NEC in infants with CCHD.
- A cautious feeding strategy is advised post-cardiac catheterisation.
Background:
Infants with congenital cyanotic heart disease are at increased risk of developing necrotising enterocolitis (NEC). We examined a cohort of infants with congenital cyanotic heart disease in order to assess the role of cardiac catheterisation in the pathogenesis of NEC.
Methods:
Sixty-five infants with congenital cyanotic heart disease were assessed in a retrospective study. The incidence of gastrointestinal complications was compared between infants who required cardiac catheterisation and those who did not.
Results:
There were 38 infants who required cardiac catheterisation and 27 who did not. Both groups were similar for known risk factors for NEC. Eleven of the catheterised infants developed bloody stools versus 4 of the non-catheterised infants (OR 2.34; 95% CI 0.65-8.36). Five of the catheterised infants developed classical NEC versus none of the non-catheterised infants (OR 4.24; 95% CI 0.47-38.5). Four of the five infants who developed NEC did so during re-introduction of feeds following cardiac catheterisation.
Conclusion:
Infants with congenital cyanotic heart disease appear to be at a greater risk of gastrointestinal complications including necrotising enterocolitis in the days following cardiac catheterisation. We suggest a more cautious approach to feeding is required during this period.