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Poor post-operative growth in infants with two-ventricle physiology

Published online by Cambridge University Press:  09 March 2011

Jeffrey B. Anderson ,
Bradley S. Marino ,
Sharon Y. Irving ,
J. Felipe García-España ,
Chitra Ravishankar ,
Virginia A. Stallings  and
Barbara Medoff-Cooper
Jeffrey B. Anderson*
Affiliation:
Division of Cardiology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America
Bradley S. Marino
Affiliation:
Division of Cardiology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America Division of Critical Care Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America
Sharon Y. Irving
Affiliation:
School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
J. Felipe García-España
Affiliation:
Division of Cardiology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
Chitra Ravishankar
Affiliation:
Division of Cardiology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
Virginia A. Stallings
Affiliation:
Division of Gastroenterology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
Barbara Medoff-Cooper
Affiliation:
School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
*
Correspondence to: J. B. Anderson, MD, MPH, Division of Cardiology, Department of Pediatric Cardiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, ML 2003, Cincinnati, 45255 Ohio, United States of America. Tel: 513 636 3865; Fax: 513 636 3952; E-mail: [email protected]
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Abstract

Background

Adequate nutritional support is essential for normal infant growth and development. Infants with congenital cardiac disease are known to be at risk for growth failure. We sought to describe perioperative growth in infants undergoing surgical repair of two-ventricle congenital cardiac disease and assess for predictors of their pattern of growth.

Materials and methods

Full-term infants who underwent surgical repair of two-ventricle congenital cardiac disease at a single institution were enrolled in a retrospective cohort study performed following a larger prospective study. Infants with facial, gastrointestinal, or neurologic anomalies, trisomy chromosomal abnormality, birth weight less than 2500 grams, or those transferred to another institution before discharge home were excluded. The primary outcome was change in weight-for-age z score from surgery to discharge. Our secondary outcome variable was post-operative hospital length of stay.

Results

A total of 76 infants met the inclusion criteria. Medain age at surgery was 5 days with a range from 1 to 44. The median weight-for-age z score at surgery was −0.2 with a range from −2.9 to 2.8 and by discharge had dropped to −1.2 with a range from −3.4 to 1.8. The median change in weight-for-age z score from surgery to discharge was −1.0 with a range from −2.3 to 0.2. Delayed post-operative nutrition (p < 0.001) and reintubation following initial post-operative extubation (p = 0.001) were associated with decrease in weight-for-age z score.

Conclusions

Infants undergoing repair of two-ventricle congenital cardiac disease had poor growth in the post-operative period. This may be mitigated by early initiation of post-operative nutrition.

Keywords

Congenital cardiac diseaseinfant weightnutritional status
Type
Original Articles
Information
Cardiology in the Young , Volume 21 , Issue 4 , 12 July 2011 , pp. 421 - 429
Copyright
Copyright © Cambridge University Press 2011

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