Pre-operative enteral feeding in single-ventricle CHD patients and necrotising enterocolitis risk.

Creator(s)

Lucy Pappas, Children's Mercy Kansas CityFollow
Lori A. Erickson, Children's Mercy Kansas CityFollow
Amy Ricketts, Children's Mercy Kansas CityFollow
Matthew L. Moehlmann, Children's Mercy Kansas City
Aaron M. Hahn, Children's Mercy Kansas CityFollow
John M. Daniel IV, Children's Mercy Kansas CityFollow

Document Type

Article

Publication Date

2-2024

Identifier

DOI: 10.1017/S1047951123001580

Abstract

INTRODUCTION: Enteral feeding prior to cardiac surgery has benefits in pre-operative and post-operative patient statuses. In 2020, to increase pre-operative feeding for single-ventricle patients prior to stage 1 palliation, an enteral feeding algorithm was created. The aim of this study is to monitor the impact of our practice change with the primary outcome of necrotising enterocolitis incidence from birth to 2 weeks following surgical intervention.

METHODS: This is a single-site, retrospective cohort study including patients from 1 March, 2018 to 1 July, 2022. Variables assessed include demographics, age at cardiac surgery, primary cardiac diagnosis, necrotising enterocolitis pre-operative and 2 weeks post-operative cardiac surgery, feeding route, feeding type, volume of trophic enteral feeds, and near-infrared spectroscopy.

RESULTS: Following implementation of a pre-operative enteral feeding algorithm, the rate of neonates fed prior to surgery increased (39.5-75%, p = .001). The feedings included a mean volume of 28.24 ± 11.16 ml/kg/day, 83% fed breastmilk only, 44.4% tube fed, and 55.5% of infants had all oral feedings. Comparing enterally fed neonates and those not enterally fed, the necrotising enterocolitis incidence from birth to 2 weeks post-op was not significantly increased (p = 0.926).

CONCLUSION: As a result of implementing our feeding algorithm, the frequency of infants fed prior to stage I Norwood or Hybrid surgeries increased to 75%, and there was no significant change in the incidence of necrotising enterocolitis. This study confirmed that pre-operative enteral feeds are safe and are not associated with increased incidence of necrotising enterocolitis.

Journal Title

Cardiology in the young

Volume

34

Issue

2

First Page

364

Last Page

369

MeSH Keywords

Infant; Female; Infant, Newborn; Humans; Enteral Nutrition; Retrospective Studies; Enterocolitis, Necrotizing; Univentricular Heart; Fetal Diseases

Keywords

Enteral feeding; Hypoplastic left heart syndrome; Necrotising enterocolitis; Single ventricle

Recommended Citation

Pappas LB, Erickson LA, Ricketts AM, Moehlmann ML, Hahn AM, Daniel JM 4th. Pre-operative enteral feeding in single-ventricle CHD patients and necrotising enterocolitis risk. Cardiol Young. 2024;34(2):364-369. doi:10.1017/S1047951123001580