Feeding outcomes after paediatric cardiothoracic surgery: a retrospective review

Hill, Robert Gardiner; Tey, Ching Siong; Jung, Calvin; Monfort, Robert; Pettitt-Schieber, Brian; Vaughn, William; Hathaway, Campbell R; Shashidharan, Subhadra; Sharp, William G.; Wetzel, Martha

doi:10.1017/s1047951120004552

Cited by 8 publications

(4 citation statements)

References 26 publications

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“…These feeding issues translate to a need for supplemental tube feedings. More than half these infants are discharged home on tube feedings, either exclusive or combined with oral feedings [10,18,19].…”

Section: Factors Contributing To Feeding Challenges and Etiology Of G...mentioning

confidence: 99%

Feeding challenges in the newborn with congenital heart disease

Ravishankar

2022

Current Opinion in Pediatrics

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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.

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Section: Factors Contributing To Feeding Challenges and Etiology Of G...mentioning

confidence: 99%

Feeding challenges in the newborn with congenital heart disease

Ravishankar

2022

Current Opinion in Pediatrics

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“…Previous studies that have investigated postoperative feeding protocols have examined patients with single or biventricular congenital heart defects rather than those with vascular rings [ 15 , 16 ]. These studies also focus solely on implementing feeding protocols in the immediate postoperative period in critical care units rather than on feeding difficulties that persist long after repair [ 17 , 18 ].…”

Section: Reviewmentioning

confidence: 99%

Feeding Difficulties Following Vascular Ring Repair: A Contemporary Narrative Review

Fisenne¹,

Burns²,

Dhar³

2022

Cureus

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Vascular rings are congenital abnormalities of the aortic arch vascular system that compress the trachea and esophagus. A review of long-term outcomes suggests that chronic feeding difficulties can persist following surgical repair of vascular rings. Previous reports of postoperative vascular ring division outcomes indicate that chronic esophageal symptoms may persist following repair, though most available data focuses on persistent respiratory symptoms. It is therefore the aim of this article to summarize and organize recent evidence reporting the frequency, presentation, and management of feeding difficulties following vascular ring repair in pediatric patients. Pathophysiologic mechanisms for postoperative esophageal symptoms may include residual compression from an unresected diverticulum of Kommerell or delayed repair leading to chronic esophageal dysmotility despite correction of esophageal compression. Guidance on the management of feeding difficulties following vascular ring repair is limited. The authors describe success in one case with nasogastric tube feeding and interdisciplinary evaluation. Consensus regarding the management of feeding difficulty following vascular ring repair is needed.

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“…Infants with CHD who require surgical intervention often experience difficulties with oral feeding. 1 In particular, infants with single-ventricle physiology have been found to be at risk for poor feeding. 2 In a recent study of single-ventricle patients, 57% required tube feeding at the time of discharge from the neonatal hospitalisation and 39% needed a feeding tube at one year of age.…”

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confidence: 99%

Feeding at 6–12 months in infants with CHD

Pados

Harrison²

2022

Cardiol Young

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Background: Feeding difficulty is common in infants with CHD. Objective: The purpose of this study was to describe the feeding skills and behaviours of infants with CHD at 6–12 months of age and explore relationships between feeding, gastrointestinal distress, and gastroesophageal reflux. Methods: Parents of 30 infants with CHD completed online surveys when their infant was 6, 8, 10, and 12 months old. Surveys included parent-report measures of feeding skills (Child Oral and Motor Proficiency Scale), feeding behaviours (Pediatric Eating Assessment Tool), symptoms of gastrointestinal distress (Infant Gastrointestinal Symptoms Questionnaire), and gastroesophageal reflux (Infant Gastroesophageal Reflux Questionnaire-Revised). Results: We found that 95, 32, 67, and 30% of infants were delayed in their feeding skill development at 6, 8, 10, and 12 months, respectively. Symptoms of problematic feeding behaviours were similarly high, with 90, 62, 29, and 38% of infants meeting criteria for problematic feeding at 6, 8, 10, and 12 months, respectively. Feeding skills and behaviours were related but unique contributors. Feeding behaviours were related to both gastrointestinal distress and gastroesophageal reflux, but feeding skills were rarely related to either. Conclusions: Delayed acquisition of feeding skills and problematic feeding were common in infants with CHD. Infants with more gastrointestinal and gastroesophageal reflux symptoms had more symptoms of problematic feeding behaviours. Clinical Implications: Comprehensive assessment, targeted interventions, and early involvement of feeding specialists are important to support feeding in infants with CHD through at least the first year of life.

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Feeding outcomes after paediatric cardiothoracic surgery: a retrospective review

Cited by 8 publications

References 26 publications

Feeding challenges in the newborn with congenital heart disease

Feeding challenges in the newborn with congenital heart disease

Feeding Difficulties Following Vascular Ring Repair: A Contemporary Narrative Review

Feeding at 6–12 months in infants with CHD

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