Nutritional support via percutaneous endoscopic gastrostomy in children with cardiac disease experiencing difficulties with feeding

Ciotti, Giovanna; Holzer, Ralf; Pozzi, Marco; Dalzell, Mark

doi:10.1017/s1047951102000975

Cited by 31 publications

(24 citation statements)

References 12 publications

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“…There exists very little previous data examining enteral feeding patterns and outcomes among patients with congenital heart disease, a population in which malnutrition has long been recognized to be common [5,6] . Schwalbe-Terilli et al [7] evaluated the caloric intake of 100 neonates receiving enteral nutrition after cardiac surgery, 52 with biventricular cardiac defects and 48 with a functional single ventricle.…”

Section: Discussionmentioning

confidence: 99%

“…The types of surgical repair included Norwood procedure in 14 infants (20.9%), hybrid procedure in 4 (6%), TAPVR repair in 9 cases (13.4%) and coarctation/interrupted aortic arch repair in 8 infants (11.9%). A teratology repair was performed in 3 infants (4.5%) and a modified BT shunt placed in 15 infants (22.4%) with tetralogy physiology [6] , hypoplastic right heart [5] , transposition of great vessels [2] , Ebstein anomaly [1] and tricuspid atresia [1] . Truncus repair was done in 6 (9%), arterial switch procedure in 4 infants (6%) and systemic to pulmonary artery shunts in 2 cases (3%), pulmonary artery banding and heart transplantation in 1 case each (1.5%).…”

Section: Demographic and Clinical Characteristicsmentioning

confidence: 99%

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Enteral Feeding of Neonates with Congenital Heart Disease

2010

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Background: Despite their putative impact on post-operative outcomes, there is paucity of data on enteral feeding practices of neonates with congenital heart disease (CHD). Objectives: To examine feeding patterns among neonates with CHD before and after surgical repair and determine the incidence of and to identify risk factors associated with feeding-related morbidities. Methods: Retrospective data review of neonates with CHD who underwent surgical repair within the first month of life. SPSS software (version 17) was used for analyses and p < 0.05 taken as significant. Results: The median (range) gestational age of our cohort (n = 67) was 39 weeks (32–41) and birth weight 3,100 g (1,615–4,280). Ductal-dependent lesions were diagnosed in 52 infants (77.6%). Prior to surgery, feedings were initiated in 62 infants (92.5%) at a median age of 2.5 days (1–18); 100 ml/kg daily intake was achieved in 47 infants (70.1%) at 5 days (1–20) and full feeds in 22 infants (32.8%). Postoperative enteral feeds were started 3 days (1–20) after surgery in 66 infants (98.5%) and intake of 100 ml/kg/day was reached in 64 infants at 5 postoperative days (1–29). Four infants (5.9%) died; 27 (40.3%) were on at least partial gavage feedings at the time of discharge home. NEC was diagnosed in 2 infants. On regression analysis, cardiopulmonary bypass (p = 0.024) and age at which full feeds were attained prior to surgery (p = 0.039) were significantly associated with death and/or gavage at discharge. Conclusions: The majority of infants with CHD achieve moderate enteral intake prior to surgery, even while on prostaglandins. Despite this and the early initiation of postoperative enteral feeds, many infants need gavage feeds at discharge. Evidence-based feeding strategies for this high-risk population are critical to improving outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Demographic and Clinical Characteristicsmentioning

confidence: 99%

Enteral Feeding of Neonates with Congenital Heart Disease

2010

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“…Studies have shown that tube feeding can be beneficial to children with a variety of conditions such as chronic renal failure, liver disease, or heart disease, where calorie intake might otherwise be inadequate and lead to malnutrition [1][2][3]. Other children may have structural abnormalities of the digestive tract or absorption problems, which require tube feeding and/or total parenteral nutrition.…”

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confidence: 99%

Tube Feeding in Infancy: Implications for the Developmentof Normal Eating and Drinking Skills

2005

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Tube feeding is commonly used as a method of giving children nutrition while they are being treated for disease. While this is an effective way of ensuring a child thrives and grows, research studies and clinical experience have shown that long-term oral feeding difficulties often arise when the child no longer requires tube feeding. This article gives a critical review of the literature on tube feeding and its effect on normal eating and drinking skills. While few studies have followed a rigorous research design, there is enough literature to identify a number of factors which may be implicated in later feeding difficulties and which therefore need further exploration in research studies. These factors include age at which oral feeding commences, medical complications, exposure to taste and textures during sensitive periods, aversive experiences, and different methods of delivering tube feeds.

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“…It could also be shown that weaning is harder if the patients are older (6% per month). Our cardiological ill group in mean is older than the others and so we believe that overfeeding before surgery [5] is the main cause for better weaning…”

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confidence: 89%