Title

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

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