Feeding challenges in the newborn with congenital heart disease

Abstract

Purpose of reviewFeeding challenges and growth failure are lifelong issues for infants with congenital heart disease. The purpose of this review is to summarize the literature on the topic from North America.Recent findingsDespite recognition of feeding challenges and ongoing national collaboration, >50% of infants with univentricular physiology continue to require supplemental tube feeds at the time of discharge from neonatal surgery. Preoperative feeding is now commonly used in prostaglandin dependent neonates with congenital heart disease. The value of a structured nutritional program with establishment of best practices in nutrition is well recognized in the current era. Despite implementation of these best practices, neonates undergoing cardiac surgery continue to struggle with weight gain prior to discharge. This suggests that there is more to growth than provision of adequate nutrition alone.SummaryThe National Pediatric Cardiology Quality Improvement Collaborative continues to play a major role in optimizing nutrition in infants with congenital heart disease. This among other registries underscores the importance of collaboration in improving overall outcomes for children with congenital heart disease. Nurses should be encouraged to lead both clinical and research efforts to overcome feeding challenges encountered by these children.

Association between the dynamic movement of hyperechoic foci and patients'/sonographic outcomes among pediatric patients with portal venous gas following a cardiac event

“…Bell's classification is useful to manage patients with necrotizing enterocolitis. Our results regarding patient outcomes were consistent with those of previous reports 1,28,30,40 . Sonographic outcomes, such as the interval from PVG detection to diminishment, were not associated with Bell's classification.…”

“…Table 1 Figures (1)(2)(3)(4)(5)(6) To objectively evaluate the dynamic movement of the hyperechoic foci during review of the sonographic movie, the presence or absence of the following hyperechoic foci movements was evaluated: Step 2 (Table 1), hyperechoic foci within the mesenteric vein (including the splenic, superior mesenteric, or inferior mesenteric vein) (Figures 1, 2, 3, and 6); Steps 3 and 4 (Table 1), toand-fro movement of hyperechoic foci within the intrahepatic portal vein (Figures 5 and 6); Steps 4 and 5 (Table 1), distribution of the hyperechoic foci in the left segment or both the left and right segments (Figures 2, 3, 4, and 6); Steps 4 and 5 (Table 1), line or punctate shape of the hyperechoic foci in the liver (Figures 2 and 3); Steps 4 and 5 (Table 1), detection of hyperechoic foci within both the portal and hepatic veins (Figure 1).…”

“…Pediatric patients with congenital heart diseases require surgical repair. To perform these surgical repairs, an increase in body weight is important 1–3 . Therefore, enteral nutrition needs to be initiated as early as possible.…”

“…To perform these surgical repairs, an increase in body weight is important. [1][2][3] Therefore, enteral nutrition needs to be initiated as early as possible. However, necrotizing enterocolitis may occur during the management of pediatric patients with congenital heart diseases, resulting in bowel rest, delayed enteral nutrition, and difficulty in gaining body weight.…”

Somatic growth in congenital heart disease—A balance between genetic potential and treatment effects

“…A major commitment to nutritional follow‐up is needed to succeed with surgical treatment of the most complex CHD. There is a large and steadily growing literature about nutritional management of infants and children who are treated for CHD 1,2 …”