Impact of Nutrition Support Team on Postoperative Nutritional Status and Outcome of Patients with Congenital Gastrointestinal Anomalies

• Published in: Middle East journal of digestive diseases 2020-04, Vol.12 (2), p.116-122
• Main Authors: Zarei-Shargh, Parisa, Yuzbashian, Emad, Mehdizadeh-Hakkak, Atieh, Khorasanchi, Zahra, Norouzy, Abdolreza, Khademi, Gholamreza, Imani, Bahareh
• Format: Article
• Language: English
• Subjects: Birth weight; Congenital diseases; Dietitians; Enteral nutrition; Hospitals; Intensive care; Mortality; Nutrition; Nutritional status; Parenteral nutrition; Patients; Pediatrics; Prescription drugs; Surgery; Ventilators
• ISSN: 2008-5230; 2008-5249
• DOI: 10.15171/mejdd.2020.171

Different variables such as age, sex, prematurity, type of anomaly, birth weight, use of vasoactive drugs, weight gain in NICU, length of NICU stay, postoperative enteral nutrition initiation, duration of mechanical ventilation, mortality rate, maximum of blood sugar, the amount of calorie delivered to the calorie requirement ratio, and distribution of energy from enteral or parenteral roots were compared between the patients of two NICUs. The provision of adequate calorie intake is under the influence of nutritive support. [...]minimal trace elements and micronutrient supplementation are included in early parenteral nutrition (PN) orders.3 Patients who undergo GI surgeries because of congenital anomalies need special nutritional care and management and should be closely supported by a nutrition support team (NST).4 Postsurgical nutritional support in neonates with congenital anomalies is different from adults and is complicated by prematurity, operative stress, critical illness, and sepsis. [...]adequate and even higher nutrition supply should be considered in these patients for postsurgical healing, and normal growth and development.5 Many studies demonstrate the cost-saving and improvement in patients' outcomes after the implementation of NST.6,7 American society for parenteral and enteral nutrition (Aspen) at last updated guideline reported the existence of NST in 42% of the respondent hospitals in 2010.8 Nutrition support professionals include physicians, nurses, dietitians, and pharmacists who manage several issues regarding complete nutritional support such as appropriate nutritional assessment in each patient, assignment of macro- and micronutrient requirement, administration of proper enteral and parenteral nutrition, and monitoring the complications of feeding.9 In addition, patient care might be enhanced by NST through improving nutritional assessment and proper nutrient delivery and reducing infective, mechanical, and metabolic complications.10 In this study, we evaluated the impact of NST on postsurgical nutritional status and surgery outcomes in patients with congenital anomalies who underwent repair operation in both NST-supported and not supported NICUs in Dr. Sheikh Pediatric Hospital, Mashhad, Iran. Demographic variables included age, sex, prematurity, birth weight, the highest level of plasma glucose during admission, and type of anomalies. [...]the duration of mechanical ventilation that suggests the difficulty in spontaneous breathing