Early weight trends after congenital heart surgery and their determinants

Abstract

Background:Early weight trends after cardiac surgery in infants from low- and middle-income countries where the majority are undernourished have not been defined. We studied the early post-operative weight trends to identify specific factors associated with early weight loss and poor weight gain after discharge following congenital heart surgery in consecutive infants undergoing cardiac surgery at a referral hospital in Southern India.Methods:This was a prospective observational study. Weights of the babies were recorded at different time points during the hospital stay and at 1-month post-discharge. A comprehensive database of pre-operative, operative, and post-operative variables was created and entered into a multivariate logistic regression analysis model to identify factors associated with excessive early weight loss after cardiac surgery, and poor weight gain following hospital discharge.Results:The study enrolled 192 infants (mean age 110.7 ± 99.9 days; weight z scores − 2.5 ± 1.5). There was a small but significant (p < 0.001) decline in weight in the hospital following surgery (1.6% decline (interquartile range −5.3 to +1.7)); however, there was substantial growth following discharge (26.7% increase (interquartile range 15.3–41.8)). The variables associated with post-operative weight loss were cumulative nil-per-oral duration and cardiopulmonary bypass time, while weight gain following discharge was only associated with age.Conclusion:Weight loss is almost universal early after congenital heart surgery and is associated with complex surgery and cumulative nil-per-oral duration. After discharge, weight gain is almost universal and not associated with any of the perioperative variables.

Outcome and factors associated with undernutrition among children with congenital heart disease

“…Undernutrition was significantly associated with increased risk of death in our study. Nutritional status may impact on the outcomes of cardiac surgery [18][19][20]. Children undergoing cardiac surgery, who are underweight, may be associated with a higher 30-day mortality.…”

Faktor yang Memengaruhi Tumbuh Kejar Anak Pascaoperasi Koreksi Defek Septum Ventrikel

“…11 Waktu optimal untuk melakukan operasi koreksi tergantung pada manifestasi klinis yang muncul. 10 Perbedaan usia saat dilakukan operasi koreksi ini terjadi karena beberapa pasien yang dirujuk saat usia lebih dari lima tahun dan sebagian pasien dapat mengalami perbaikan dengan terapi medikamentosa gagal jantung. Pada penelitian terdahulu, penundaan usia operasi koreksi dapat menyebabkan gangguan pertumbuhan kronis yang lebih berat dan juga memengaruhi tinggi badan jangka panjang.…”

“…8,9 Peningkatan status gizi setelah koreksi PJB juga berhubungan dengan usia muda saat dilakukan koreksi, keadaan malnutrisi berat dan keterlambatan perkembangan sebelum pembedahan. 10,11 Tujuan penelitian ini adalah untuk menganalisis faktor yang memengaruhi tumbuh kejar anak pascaoperasi koreksi DSV.…”

The influence of body fat percentage in the anthropometric prediction of cardiac structure size in infants

“…Children with congenital heart disease are potentially at high risk of malnutrition because of fluid restriction associated with congestive heart failure, prolonged mechanical ventilation, and perioperative intensive care [1][2][3] . Malnutrition during the newborn period leads to excessive fat accumulation, subsequent metabolic syndromes, and even impaired neurodevelopment 4 .…”