A Multi-Interventional Nutrition Program for Newborns with Congenital Heart Disease

• Published in: The Journal of pediatrics 2021-01, Vol.228, p.66-73.e2
• Main Authors: O'Neal Maynord, Patrick, Johnson, Melissa, Xu, Meng, Slaughter, James C., Killen, Stacy A.S.
• Format: Article
• Language: English
• Subjects: Cardiac Surgical Procedures - methods; Disease Management; Female; Follow-Up Studies; Heart Defects, Congenital - physiopathology; Heart Defects, Congenital - surgery; Humans; Infant, Newborn; Length of Stay - trends; Male; Nutritional Status; Postoperative Complications - mortality; Postoperative Complications - prevention & control; Prognosis; Survival Rate - trends; United States - epidemiology; Weight Gain - physiology
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2020.08.039

To evaluate how outcomes changed in newborns undergoing surgery for congenital heart disease after implementation of a standardized preoperative and postoperative nutrition program. We performed a single-center cohort study of newborns who underwent cardiac surgery between September 2008 and July 2015. We evaluated growth and feeding outcomes in the 2 years of preprogram time (phase 0), in the 2 years after initiation of a postoperative feeding algorithm (phase 1), and in the 2 years following introduction of a preoperative feeding program (phase 2) using traditional statistics and quality improvement methods. The study included 570 newborns with congenital heart disease. Weight-for-age z-score change from birth to hospital discharge significantly improved from phase 0 (−1.02 [IQR, −1.45 to −0.63]) to phase 1 (−0.83 [IQR, −1.25 to −0.54]; P = .006), with this improvement maintained in phase 2 (−0.89 [IQR, −1.30 to −0.56]; P = .017 across phases). Gastrostomy tube use decreased significantly (25% in phase 0 vs 12% and 14% in phases 1 and 2; P