Predictors of the inability to achieve full oral feeding in postoperative infants with CHD.
Predictors of the inability to achieve full oral feeding in postoperative infants with CHD.
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患有先心病的术后婴儿无法实现完全经口喂养的预测因素。
DOI：
10.1017/s104795112300313x
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发表时间：
2024
影响因子：
1
通讯作者：
Lynch,JenniferM
中科院分区：
文献类型：
--
作者：
Jacobwitz,Marin;Irving,SharonY;Moriarty,Helene;Yost,Jennifer;Vossough,Arastoo;Licht,DanielJ;Lynch,JenniferM
目的：对于需要早期手术的复杂CHD新生儿，不良的经口喂养是导致生长困难的一个已知因素。这些婴儿中几乎有60%在出院时没有实现完全的经口喂养。本研究的目的是确定预测因素无法实现充分的口服喂养出院后，在复杂的CHD新生儿手术干预与cardiopulmonarybyprost.Study DesignA回顾性分析的前瞻性研究192个足月新生儿复杂的CHD进行。逐步选择logistic回归模型被开发用于预测出院时的经口喂养状态。结果58%（112/192）的新生儿出院时未能完全经口进食。Logistic回归模型确定深低温停循环和再插管的持续时间是无法实现完全经口喂养的预测因素。在出院时实现完全经口喂养的新生儿中（42%），仅7.5%在术后第10天后实现。脑成熟，脑损伤，术前经口喂养的充分术后oral feeding.ConclusionsMany婴儿CHD未能实现充分的经口喂养出院时的预测。深低温停循环持续时间越长和插管次数越多预示着术后喂养不良。仅为术后第10天实现完全经口喂养而延长住院时间的效用有限;应促进尽早出院，以避免因长期住院而产生的意外后果对新生儿神经发育产生负面影响。
ObjectivesPoor oral feeding is a known contributor to growth challenges in neonates with complex CHD who require early surgery. Almost 60% of these infants do not achieve full oral feeding by hospital discharge. This study’s objective was to identify predictors of the inability to achieve full oral feeding by discharge in neonates with complex CHD following surgical intervention with cardiopulmonary bypass.Study DesignA retrospective analysis of a prospective study of 192 full-term neonates with complex CHD was performed. A stepwise selection logistic regression model was developed to predict oral feeding status at hospital discharge. Univariate subgroup analysis was performed with groups determined based on a CHD classification system.Results58% of neonates (112/192) failed to achieve full oral feeding by hospital discharge. A logistic regression model identified duration of deep hypothermic circulatory arrest and reintubation as predictors of the inability to achieve full oral feeding. Among neonates who achieved full oral feeding by discharge (42%), only 7.5% did so after postoperative day 10. Brain maturation, brain injury, and preoperative oral feeding were not predictors of full postoperative oral feeding.ConclusionsMany infants with CHD fail to achieve full oral feeding by time of hospital discharge. Longer duration of deep hypothermic circulatory arrest and increased number of intubations were predictive of poor feeding after surgery. Prolonging hospitalisation solely to achieve full oral feeding after postoperative day ten is of limited utility; earlier discharge should be promoted to avoid negative impacts on neonatal neurodevelopment as unintended consequences of lengthy hospitalisations.