Preoperative Feeding Neonates With Cardiac Disease.
Preoperative Feeding Neonates With Cardiac Disease.
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DOI：
10.1177/2150135116668833
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发表时间：
2017-01
影响因子：
0.9
通讯作者：
Zyblewski SC
中科院分区：
文献类型：
--
作者：
Scahill CJ;Graham EM;Atz AM;Bradley SM;Kavarana MN;Zyblewski SC
接受心脏手术的新生儿发生坏死性小肠结肠炎（NEC）的可能性在很大程度上导致了广泛的喂养实践变化和术前期间开始肠内喂养的犹豫，特别是那些患有左心发育不良综合征的患者。对2011年7月至2013年7月期间在一家机构接受心脏手术的新生儿进行了回顾性病历审查。本研究的主要目的是确定术前喂养是否与需要心脏手术的新生儿坏死性小肠结肠炎（NEC）有关。单因素和多因素分析，以评估术前喂养和NEC之间的关系。次要结局包括生长障碍、总呼吸机天数和总住院时间。130名需要心脏手术的连续新生儿被纳入分析。61%（n = 79）发生术前进食。NEC的总患病率为9%（12/130），包括3例手术NEC。术前喂养组和NPO组的NEC患病率无差异。术前NPO与较长的呼吸机依赖天数相关（p = 0.01），但与生长衰竭恶化或住院时间延长无关。在本研究队列中，术前喂养与NEC无关。需要进行更大规模的前瞻性研究来评估心脏病新生儿术前喂养的安全性和益处。
The potential for necrotizing enterocolitis (NEC) in neonates undergoing cardiac surgery has contributed largely to wide feeding practice variations and a hesitation to initiate enteral feeding during the preoperative period, specifically those patients with hypoplastic left heart syndrome. A retrospective chart review of neonates undergoing cardiac surgery at a single institution between July 2011 and July 2013 was performed. The primary objective of this study was to determine if preoperative feeding was associated with necrotizing enterocolitis (NEC) in neonates requiring cardiac surgery. Univariable and multivariable analyses were performed to evaluate the relationship between preoperative feeding and NEC. Secondary outcomes including growth failure, total ventilator days and total length of stay were analyzed. One hundred thirty consecutive neonates who required cardiac surgery were included in the analysis. Preoperative feeding occurred in 61% (n=79). The overall prevalence of NEC was 9% (12/130), including 3 neonates with surgical NEC. There was no difference in the prevalence of NEC between the preoperative feeding and nil per os (NPO) groups. NPO preoperatively was associated with longer ventilator dependent days (p=0.01) but was not associated with worsened growth failure or longer length of stay. In this study cohort, preoperative feeding was not associated with NEC. Larger prospective studies evaluating the safety and benefits of preoperative feeding in cardiac neonates are warranted.