Reducing variation in feeding newborns with congenital heart disease

Simsic, Janet M.; Carpenito, Kirby; Kirchner, Kristin; Peters, Stéphanie; Miller‐Tate, Holly; Joy, Brian F.; Galantowicz, Mark

doi:10.1111/chd.12435

Cited by 17 publications

(10 citation statements)

References 27 publications

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“…Some of the studies emphasize caloric delivery while others focus on standardization and decrease practice variation among providers. 8 One major difference compared with other prior studies such as Simsic et al 8 is every patient in our inclusion cohort underwent CPB. 8 Newcombe and Fry-Bowers 2 excluded patients with hemodynamic instability defined as patients on Milrinone infusions or inotropic drips.…”

Section: Discussionmentioning

confidence: 82%

“… 5 , 6 Studies have also shown patients receiving TPN have an increased risk of a central line–associated blood stram infections (CLABSI) and a reduction of time on TPN is beneficial to patients. 7 Adherence to a feeding protocol may decrease these risks and improve quality of care by reducing practice variation among providers.. 1 , 4 , 8 , 9 …”

Section: Introductionmentioning

confidence: 99%

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Evaluating the Impact of a Feeding Protocol in Neonates before and after Biventricular Cardiac Surgery

Furlong-Dillard

Neary

Marietta

et al. 2018

Pediatric Quality &Amp; Safety

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Section: Discussionmentioning

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Evaluating the Impact of a Feeding Protocol in Neonates before and after Biventricular Cardiac Surgery

Furlong-Dillard

Neary

Marietta

et al. 2018

Pediatric Quality &Amp; Safety

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“…Similarly, another randomized study evaluated the use of human milk fortifier and described a trend in reduction in length of MV, ICULOS, and HLOS. A case control study evaluated the implementation of a feeding protocol for the initiation and advancement of enteral feeding in children with CHD and observed a reduction in HLOS after the implementation.…”

Section: Discussionmentioning

confidence: 99%

Tolerability and Effects of the Use of Energy‐Enriched Infant Formula After Congenital Heart Surgery: A Randomized Controlled Trial

Scheeffer

Ricachinevsky

Freitas

et al. 2019

J Parenter Enteral Nutr

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Background Undernutrition is a common problem among children with congenital heart disease (CHD) and may lead to poorer surgical outcomes. A higher intake of energy during the postoperative period of CHD surgery seems to be associated with better outcomes. This study aimed to investigate the effect of the use of energy‐enriched formula (EE‐formula) compared with normocaloric formula during 30 days after CHD surgery. Methods A randomized controlled trial with patients undergoing heart surgery in a tertiary hospital in southern Brazil from March 2017 to December 2017 was performed. The intervention group received EE‐formula (1 kcal/mL), and the control group received normocaloric formula (0.67 kcal/mL). The researcher in charge of anthropometric evaluation was blinded to the randomization. Results Fifty‐nine patients were included; 30 in control group and 29 in intervention group. There were no statistically significant differences between groups regarding age, gender, anthropometry, and surgical risk classification after randomization. A statistically significant difference in z‐score of weight for age and in weight gain variation rate between groups after intervention was observed. Antibiotic use was less frequent in the intervention group, and hospital length of stay was shorter. General gastrointestinal side effects were similar between groups, whereas diarrhea was more frequent in the intervention group. However, this side effect was limited and had spontaneous resolution in 4 out of 6 cases. Conclusion This study demonstrates that EE‐formula use after heart surgery of patients with CHD is well tolerated and may improve short‐term nutrition outcome, decrease hospital stay, and reduce antibiotic use.

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“…A future collaboration between the American and European societies might improve upcoming guidelines and help implement the recommendations worldwide. Despite these limitations, this work has provided an updated summary of the existing evidence, including questions around term neonates, which are not dealt with by other recommendations or guidelines, yet comprise a significant amount of the European PICU population [29,30].…”

Section: Limitationsmentioning

confidence: 99%

Nutritional support for children during critical illness: European Society of Pediatric and Neonatal Intensive Care (ESPNIC) metabolism, endocrine and nutrition section position statement and clinical recommendations

et al. 2020

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Background: Nutritional support is considered essential for the outcome of paediatric critical illness. There is a lack of methodologically sound trials to provide evidence-based guidelines leading to diverse practices in PICUs worldwide. Acknowledging these limitations, we aimed to summarize the available literature and provide practical guidance for the paediatric critical care clinicians around important clinical questions many of which are not covered by previous guidelines. Objective:To provide an ESPNIC position statement and make clinical recommendations for the assessment and nutritional support in critically ill infants and children. Design: The metabolism, endocrine and nutrition (MEN) section of the European Society of Pediatric and NeonatalIntensive Care (ESPNIC) generated 15 clinical questions regarding different aspects of nutrition in critically ill children. After a systematic literature search, the Scottish Intercollegiate Guidelines Network (SIGN) grading system was applied to assess the quality of the evidence, conducting meta-analyses where possible, to generate statements and clinical recommendations, which were then voted on electronically. Strong consensus (> 95% agreement) and consensus (> 75% agreement) on these statements and recommendations was measured through modified Delphi voting rounds. Results:The final 15 clinical questions generated a total of 7261 abstracts, of which 142 publications were identified relevant to develop 32 recommendations. A strong consensus was reached in 21 (66%) and consensus was reached in 11 (34%) of the recommendations. Only 11 meta-analyses could be performed on 5 questions. Conclusions:We present a position statement and clinical practice recommendations. The general level of evidence of the available literature was low. We have summarised this and provided a practical guidance for the paediatric critical care clinicians around important clinical questions.There is a lack of high-quality evidence to guide nutrition in paediatric critical illness. This position statement and clinical recommendations summarise the existing evidence around 15 of the most important clinical questions, and where no evidence is available, suggest good clinical practice.

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Reducing variation in feeding newborns with congenital heart disease

Cited by 17 publications

References 27 publications

Evaluating the Impact of a Feeding Protocol in Neonates before and after Biventricular Cardiac Surgery

Evaluating the Impact of a Feeding Protocol in Neonates before and after Biventricular Cardiac Surgery

Tolerability and Effects of the Use of Energy‐Enriched Infant Formula After Congenital Heart Surgery: A Randomized Controlled Trial

Nutritional support for children during critical illness: European Society of Pediatric and Neonatal Intensive Care (ESPNIC) metabolism, endocrine and nutrition section position statement and clinical recommendations

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