Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Oct;10(10):2439-2448.
doi: 10.21037/tp-21-360.

Early high-energy feeding in infants following cardiac surgery: a randomized controlled trial

Xi Chen #  1 , Mingjie Zhang #  1 , Yixiao Song  1 , Yiwen Luo  1 , Liping Wang  1 , Zhuoming Xu  1 , Nan Bao  2
Affiliations

Early high-energy feeding in infants following cardiac surgery: a randomized controlled trial

Xi Chen et al. Transl Pediatr. 2021 Oct.

Abstract

Background: Effective nutrition programs are beneficial for nutritional recovery in infants. Few studies have focused on the effect of early high-energy feeding after open heart surgery. This study sought to assess the effects of early high-energy feeding in infants after congenital heart surgery.

Methods: Patients at a tertiary pediatric cardiology center who underwent open heart surgery between July 2016 and July 2018 were recruited and randomly allocated to 1 of the following 2 groups: (I) the intervention group (postoperative early high-energy feeding; n=124); and (II) the control group (no intervention; n=120).The primary endpoints of average energy delivery and growth Z-scores [i.e., weight-for-height Z-score (WHZ), weight-for-age Z-score (WAZ), and height-for-age Z-score (HAZ)] were recorded preoperatively, during the intensive care unit (ICU) stay, at discharge, and at 1 and 3 months postoperatively. The secondary endpoints of malnutrition recovery, ventilator support time, infection rate, and cardiac ICU (CICU) stay were also recorded.

Results: A total of 244 infants were included in the study. There were no significant differences in the baseline features between the 2 groups. The intervention group received higher calories on average than the control group (44.5 vs. 34.7; P<0.001). At discharge from the ICU, the WHZ (-2.29 vs. -2.76; P<0.001) and WAZ (-3.08 vs. -3.43; P=0.005) of patients in the intervention group were higher than those of patients in the control group. Ventilator support time (P=0.004), CICU stay (P=0.045), and infection rate (P=0.001) were significantly lower in the intervention group than the control group. At 3 months post-surgery, the intervention group exhibited a higher malnutrition recovery rate than the control group (19.4% vs. 6.5%; P=0.002).

Conclusions: The administration of early high-energy feeding to infants after congenital heart surgery is associated with improved growth, reduced CICU stay, decreased ventilator support time, and reduced postoperative infection rates.

Trial registration: ClinicalTrials NCT04609358.

Keywords: Congenital heart disease; high-energy nutrition; malnutrition; randomized controlled trial.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://dx.doi.org/10.21037/tp-21-360). All authors report that this work was supported by the Key Subject Program for Clinical Nutrition from Shanghai Municipal Health Commission for Li HONG [No. 2019ZB0103]. The authors have no other conflicts of interest to declare.

Figures

Figure 1
Figure 1
Flowchart for patient screening, randomization, and follow-up.
See this image and copyright information in PMC

References

    1. Pierpont ME, Brueckner M, Chung WK, et al. Genetic Basis for Congenital Heart Disease: Revisited: A Scientific Statement From the American Heart Association. Circulation 2018;138:e653-711. 10.1161/CIR.0000000000000606 - DOI - PMC - PubMed
    1. Albers EL, Bichell DP, McLaughlin B. New approaches to neuroprotection in infant heart surgery. Pediatr Res 2010;68:1-9. 10.1203/PDR.0b013e3181df5402 - DOI - PMC - PubMed
    1. Sachdeva R, Valente AM, Armstrong AK, et al. ACC/AHA/ASE/HRS/ISACHD/SCAI/SCCT/SCMR/SOPE 2020 Appropriate Use Criteria for Multimodality Imaging During the Follow-Up Care of Patients With Congenital Heart Disease: A Report of the American College of Cardiology Solution Set Oversight Committee and Appropriate Use Criteria Task Force, American Heart Association, American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Pediatric Echocardiography. J Am Coll Cardiol 2020;75:657-703. 10.1016/j.jacc.2019.10.002 - DOI - PubMed
    1. Burch PT, Spigarelli MG, Lambert LM, et al. Use of Oxandrolone to Promote Growth in Neonates following Surgery for Complex Congenital Heart Disease: An Open-Label Pilot Trial. Congenit Heart Dis 2016;11:693-9. 10.1111/chd.12376 - DOI - PubMed
    1. Monteiro FP, de Araujo TL, Lopes MV, et al. Nutritional status of children with congenital heart disease. Rev Lat Am Enfermagem 2012;20:1024-32. 10.1590/S0104-11692012000600003 - DOI - PubMed

Associated data