Nutrition delivery and growth outcomes in infants with long-gap esophageal atresia who undergo the Foker process.
Document Type
Article
Publication Date
12-2021
Identifier
DOI: 10.1016/j.jpedsurg.2021.07.014
Abstract
BACKGROUND: Predictors of growth outcomes in patients with long-gap esophageal atresia (LGEA) are not known. We examined nutrition and growth in-hospital and post-discharge in LGEA patients who underwent the Foker Process (FP).
METHODS: Single-center, retrospective cohort study of infants with LGEA undergoing primary (non-rescue) FP from 2014 to 2020. Weight-for-age z scores (WAZ, 0 = average), macronutrient prescription, anthropometry, and clinical variables were collected. Longitudinal median regression evaluated differences in WAZ over time. Multivariable median regression examined variables associated with change in WAZ at 1 year.
RESULTS: 45 patients met criteria, with median (IQR) age at repair of 4 (2, 5.8) months and WAZ of -0.96 (-1.55, -0.40). On admission, 11% were moderately (WAZ < -2) and 9% were severely (WAZ < -3) malnourished. Lower admission WAZ was significantly associated with improvement in WAZ at 1-year follow-up (p = 0.002); EA type (59% type A), esophageal leak (16%), median days paralyzed (13), ventilated (21), on parenteral nutrition (35), or to full enteral nutrition (35) were not associated with change in WAZ. Median WAZ remained stable while in-hospital, and patients maintained their growth curves through 3-year follow-up.
CONCLUSION: Throughout infancy, most primary FP LGEA patients have weight for age that is below average. Using targeted nutritional intervention, those who present with malnutrition can still achieve adequate growth despite prolonged and complicated hospital courses.
Journal Title
Journal of pediatric surgery
Volume
56
Issue
12
First Page
2133
Last Page
2139
MeSH Keywords
Aftercare; Esophageal Atresia; Humans; Infant; Patient Discharge; Retrospective Studies
Keywords
Esophageal atresia; Foker process; Growth; Nutrition
Recommended Citation
Harrington AW, Riebold J, Hernandez K, et al. Nutrition delivery and growth outcomes in infants with long-gap esophageal atresia who undergo the Foker process. J Pediatr Surg. 2021;56(12):2133-2139. doi:10.1016/j.jpedsurg.2021.07.014
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