Predictors of the inability to achieve full oral feeding in postoperative infants with CHD

被引:0
作者
Jacobwitz, Marin [1 ,2 ]
Irving, Sharon Y. [3 ,4 ]
Moriarty, Helene [2 ]
Yost, Jennifer [2 ]
Vossough, Arastoo [5 ,6 ]
Licht, Daniel J. [1 ,5 ]
Lynch, Jennifer M. [7 ]
机构
[1] Childrens Hosp Philadelphia, Div Neurol, Philadelphia, PA 19104 USA
[2] Villanova Univ, M Louise Fitzpatrick Coll Nursing, Villanova, PA 19085 USA
[3] Childrens Hosp Philadelphia, Crit Care Nursing, Philadelphia, PA USA
[4] Univ Penn, Sch Nursing, Dept Family & Community Hlth, Philadelphia, PA USA
[5] Univ Penn, Perelman Sch Med, Philadelphia, PA USA
[6] Childrens Hosp Philadelphia, Div Neuroradiol, Philadelphia, PA USA
[7] Childrens Hosp Philadelphia, Div Cardiothorac Anesthesiol, Philadelphia, PA USA
基金
美国国家卫生研究院;
关键词
CHD; oral feeding dysfunction; neonatal cardiac surgery; neonatal; CONGENITAL HEART-DISEASE; FAILURE-TO-THRIVE; CHILDREN; MANAGEMENT; OUTCOMES; SURGERY; GROWTH; CARE;
D O I
10.1017/S104795112300313X
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objectives: Poor oral feeding is a known contributor to growth challenges in neonates with complex CHD who require early surgery. Almost 60% of these infants do not achieve full oral feeding by hospital discharge. This study's objective was to identify predictors of the inability to achieve full oral feeding by discharge in neonates with complex CHD following surgical intervention with cardiopulmonary bypass.Study Design: A retrospective analysis of a prospective study of 192 full-term neonates with complex CHD was performed. A stepwise selection logistic regression model was developed to predict oral feeding status at hospital discharge. Univariate subgroup analysis was performed with groups determined based on a CHD classification system.Results: 58% of neonates (112/192) failed to achieve full oral feeding by hospital discharge. A logistic regression model identified duration of deep hypothermic circulatory arrest and reintubation as predictors of the inability to achieve full oral feeding. Among neonates who achieved full oral feeding by discharge (42%), only 7.5% did so after postoperative day 10. Brain maturation, brain injury, and preoperative oral feeding were not predictors of full postoperative oral feeding.Conclusions: Many infants with CHD fail to achieve full oral feeding by time of hospital discharge. Longer duration of deep hypothermic circulatory arrest and increased number of intubations were predictive of poor feeding after surgery. Prolonging hospitalisation solely to achieve full oral feeding after postoperative day ten is of limited utility; earlier discharge should be promoted to avoid negative impacts on neonatal neurodevelopment as unintended consequences of lengthy hospitalisations.
引用
收藏
页码:581 / 587
页数:7
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