Nutrition Support for Children Undergoing Congenital Heart Surgeries

Abstract

Energy imbalance in infants and children with congenital heart disease (CHD) is common and influenced by age, underlying cardiac diagnoses, and presence or absence of congestive heart failure. During the surgical hospitalization period, these children are prone to nutritional deterioration due to stress of surgery, anesthetic/perfusion techniques, and postoperative care. Poor nutrition is associated with increased perioperative morbidity and mortality. This review aims to examine various aspects of nutrition in critically ill children with CHD, including (1) energy expenditure, (2) perioperative factors that contribute to energy metabolism, (3) bedside practices that are potentially able to optimize nutrient delivery, and (4) medium- to long-term impact of energy balance on clinical outcomes. We propose a nutrition algorithm to optimize nutrition of these children in the perioperative period where improvements in nutrition status will likely impact surgical outcomes.

High‐energy nutrition in paediatric cardiac critical care patients: a randomized controlled trial

“…Although current studies agree that the energy needs are highly variable between patients in the immediate postoperative period, there are several factors that can aggravate malnutrition in children and seriously affect their mortality, such as inadequate food intake, malabsorption (Hong et al, 2014), fluid restriction (Leong et al, 2014;Tume et al, 2013), various medications (Dong et al, 2012;Laura Gabriela et al, 2012) and postoperative complications (Iannucci et al, 2013;Zuluaga, 2012). Nurses are concerned about the nutrition of children, and evidence suggests that a high-energy feed might be important for some postoperative infants with CHD (Wong et al, 2015). High-energy feeds can counteract the problem with fluid restriction and inadequate food intake.…”

Dilated cardiomyopathy and severe heart failure. An update for pediatricians

“…Continuous enteral feeding is usually done during the night so as to avoid interference with the patient's routine. 33 Nutritional assessment is not easy. Weight estimation is limited by fluid changes, even during the day, and the use or not of diuretics.…”

Miocardiopatía dilatada e insuficiencia cardíaca grave. Puesta al día para el médico pediatra

“…Con frecuencia, se utiliza la alimentación enteral continua nocturna para no intervenir con la rutina habitual del paciente. 33 La evaluación nutricional no es sencilla. La estimación de peso es limitada por cambios de fluidos, incluso durante un mismo día, y el uso o no de diuréticos.…”