Impact of Type of Enteral Feeds on Early Postoperative Outcomes After Congenital Heart Surgery in Neonates and Young Infants: A Single Center Experience in a Limited Resource Environment
Impact of Type of Enteral Feeds on Early Postoperative Outcomes After Congenital Heart Surgery in Neonates and Young Infants: A Single Center Experience in a Limited Resource Environment
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肠内喂养类型对新生儿和小婴儿先天性心脏病手术后早期预后的影响：有限资源环境中的单中心经验
DOI：
10.1177/21501351231154207
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发表时间：
2023
影响因子：
0.9
通讯作者：
R. Krishna Kumar
中科院分区：
文献类型：
--
作者：
Sreepurna Ghosh;R. Balachandran;P. Neema;B. Kottayil;R. Bhaskaran;A. Sudhakar;R. Krishna Kumar
背景：众所周知，母乳可以预防感染，建议用于先天性心脏病手术（CHS）后婴儿的肠内喂养。在 Covid-19 大流行期间，并非总能获得挤出的母乳 (EBM)；因此，CHS 后继续使用 EBM 或婴儿配方奶粉 (IF) 或两者进行喂养；我们评估了肠内喂养类型对 CHS 术后早期结果的影响。方法：在一项前瞻性观察研究中，连续接受 CHS 的新生儿和 <4 个月婴儿被分为 EBM、IF 或 EBM+IF 组；研究了术后感染的发生率、通气时间、重症监护病房 (ICU) 住院时间和死亡率。结果：270 名患者中； 90 人（33.3%）接受了 EBM，89 人（32.9%）接受了 IF，91 人（33.7%）接受了 EBM+IF。 IF组新生儿较多（78.7%[IF] vs 42.2%[EBM]和52.7%[EBM+IF]，P < 0.001）且手术复杂度较高。 EBM 术后感染为 9 例（10.0%）； IF 23 (25.8%)； EBM+IF 中为 14 (15.4%) (P = .016)。 IF组（OR 2.58 [1.05-6.38]，P = .040）、术前缺乏喂养（OR 6.97 [1.06-45.97]，P = .040）和体外循环时间增加（OR 1.005 [1.001-1.010]，P = .027）与术后感染相关。 EBM 中的通气持续时间（以小时为单位）为 26 (18-47.5)；中频 47 (28-54.5)； EBM+IF 中为 40 (17.5-67) (P = .004)。 EBM 中 ICU 住院天数为 4 (3-7) 天； 6 (5-9) 中频； EBM+IF 中的 5 (3-9) (P = .001)。死亡率没有差异（P = .556）。结论：IF组新生儿比例较高，手术复杂程度较高。与接受 IF 或 EBM+IF 的患者相比，CHS 后接受 EBM 的患者术后感染更少，术后结果更好。
Background: Breast milk is known to prevent infections and is recommended for enteral feeding of infants after congenital heart surgery (CHS). During the Covid-19 pandemic, expressed breast milk (EBM) was not always available; hence, feeding after CHS was maintained with EBM or infant formula (IF) or both; we evaluated the impact of enteral feed type on early postoperative outcomes after CHS. Methods: In a prospective observational study, consecutive neonates and infants <4 months undergoing CHS were divided into EBM, IF, or EBM+IF groups; incidences of postoperative infections, ventilation duration, intensive care unit (ICU) stay, and mortality were studied. Results: Among 270 patients; 90 (33.3%) received EBM, 89 (32.9%) received IF, and 91 (33.7%) received EBM+IF. IF group had more neonates (78.7%[IF] vs 42.2%[EBM] and 52.7%[EBM+IF], P < 0.001) and greater surgical complexity. Postoperative infections were 9 (10.0%) in EBM; 23 (25.8%) in IF; and 14 (15.4%) in EBM+IF (P = .016). IF group (OR 2.58 [1.05-6.38], P = .040), absence of preoperative feeding (OR 6.97 [1.06-45.97], P = .040), and increase in cardiopulmonary bypass time (OR 1.005 [1.001-1.010], P = .027) were associated with postoperative infection. Ventilation duration in hours was 26 (18-47.5) in EBM; 47 (28-54.5) in IF; and 40 (17.5-67) in EBM+IF (P = .004). ICU stay in days was 4 (3-7) in EBM; 6 (5-9) in IF; and 5 (3-9) in EBM+IF (P = .001). Mortality did not differ (P = .556). Conclusion: IF group had a greater proportion of neonates with higher surgical complexity. Patients who received EBM after CHS had fewer postoperative infections and better postoperative outcomes compared to those receiving IF or EBM+IF.
影响因子：
2.6
作者：
Ballard, Olivia;Morrow, Ardythe L.
通讯作者：
Morrow, Ardythe L.
影响因子：
4.6
作者：
Barker, Gregory M.;O'Brien, Sean M.;Welke, Karl F.;Jacobs, Marshall L.;Jacobs, Jeffrey P.;Benjamin, Daniel K., Jr.;Peterson, Eric D.;Jaggers, James;Li, Jennifer S.
通讯作者：
Li, Jennifer S.