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

Authors

Lucy B. Pappas, Children's Mercy Hospitals and Clinics
Lori A. Erickson, Children's Mercy Hospitals and Clinics
Amy M. Ricketts, Children's Mercy Hospitals and Clinics
Matthew L. Moehlmann, Advocate Health - MidwestFollow
Aaron M. Hahn, Children's Mercy Hospitals and Clinics
John M. Daniel, Children's Mercy Hospitals and Clinics

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

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.

Type

Article

PubMed ID

37434452