Longitudinal growth in patients with single ventricle cardiac disease receiving tube‐assisted feeds

Autor: Christopher Teng, Erika Mejia, Arene Butto, Jennifer Faerber, Jonathan B Edelson, Carrie Daymont, Meryl S. Cohen, Laura Mercer-Rosa, Chitra Ravishankar
Rok vydání: 2019
Předmět:
Male
Time Factors
medicine.medical_treatment
Jejunostomy
Disease
030204 cardiovascular system & hematology
Weight Gain
Body Mass Index
Child Development
0302 clinical medicine
Risk Factors
Medicine
Longitudinal Studies
Child
Gastrostomy
Palliative Care
Age Factors
General Medicine
Patient Discharge
Norwood Operation
Cardiac surgery
Treatment Outcome
medicine.anatomical_structure
Child
Preschool
Female
medicine.symptom
Cardiology and Cardiovascular Medicine
Heart Defects
Congenital
medicine.medical_specialty
Heart Ventricles
Article
03 medical and health sciences
Enteral Nutrition
030225 pediatrics
Humans
Radiology
Nuclear Medicine and imaging
Cardiac Surgical Procedures
Retrospective Studies
business.industry
Infant
Retrospective cohort study
Body Height
Surgery
Ventricle
Pediatrics
Perinatology and Child Health
business
Weight gain
Zdroj: Congenit Heart Dis
ISSN: 1747-0803
1747-079X
Popis: Objective Children with single ventricle cardiac disease (SVCD) have poor growth in early life. Tube-assisted feeding (TF) is used to improve weight gain, but its impact on long-term growth remains unknown. We sought to compare the longitudinal growth of SVCD patients receiving TF after initial cardiac surgery with those fed entirely by mouth. Design We conducted a retrospective cohort study of SVCD patients who underwent initial surgical palliation between 1999 and 2009. We defined TF as the use of nasogastric, gastrostomy, or jejunostomy TF. We compared maximal attained growth z-scores for each year of life between TF and non-TF patients. A secondary analysis compared surgical and clinical factors between groups. Results A total of 134 patients were included; 64% were male and 68% underwent the Norwood operation. One third of patients (44) received TF. Adjusting for age, TF patients had an average of 0.56 lower weight-for-age z-score (WAZ) than non-TF patients (P = 0.007) through the age of 6 years. Longitudinal height was not affected by TF status (P = 0.15). In a subanalysis of Norwood patients, TF patients had lower WAZ at initial hospital discharge despite longer LOS. TF patients had diminished WAZ after adjusting for complications, interstage hospitalizations, and timing of subsequent operations. Conclusions In this single-center study, patients with SVCD requiring TF at discharge from initial surgical palliation had diminished WAZ at discharge and on long-term follow-up, despite controlling for other identifiable risk factors. Further investigation is needed to understand the mechanisms underlying this phenomenon and to risk stratify infants who go home on TF.
Databáze: OpenAIRE
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