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The utility of guaiac stool testing in the detection of gastrointestinal complications in infants with critical congenital heart disease

Published online by Cambridge University Press:  03 June 2019

Melanie Muller ,
Cortney Foster ,
Jessica Lee ,
Caroline Bauer ,
Casey Bor ,
Leahandra Buck ,
Faith Hicks ,
Jenni Day ,
Dayanand Bagdure  and
Adrian Holloway
...Show all authors
Melanie Muller*
Affiliation:
University of Maryland Medical Center, Pediatric Critical Care Medicine, Baltimore, MD, USA
Cortney Foster
Affiliation:
University of Maryland Medical Center, Pediatric Critical Care Medicine, Baltimore, MD, USA
Jessica Lee
Affiliation:
University of Maryland, School of Medicine, Baltimore, MD, USA
Caroline Bauer
Affiliation:
University of Maryland Medical Center, Pediatric Critical Care Medicine, Baltimore, MD, USA
Casey Bor
Affiliation:
University of Maryland Medical Center, Pediatric Critical Care Medicine, Baltimore, MD, USA
Leahandra Buck
Affiliation:
Department of Clinical Nutrition, University of Maryland Medical Center, Baltimore, MD, USA
Faith Hicks
Affiliation:
Department of Clinical Nutrition, University of Maryland Medical Center, Baltimore, MD, USA
Jenni Day
Affiliation:
Department of Nursing, University of Maryland Medical Center, Baltimore, MD, USA
Dayanand Bagdure
Affiliation:
University of Maryland Medical Center, Pediatric Critical Care Medicine, Baltimore, MD, USA
Adrian Holloway
Affiliation:
University of Maryland Medical Center, Pediatric Critical Care Medicine, Baltimore, MD, USA
Alicia Chaves
Affiliation:
University of Maryland Medical Center, Pediatric Cardiology, Baltimore, MD, USA
*
Author for correspondence: Melanie Muller, University of Maryland Medical Center, Pediatric Critical Care Medicine, 22 S. Greene Street, Baltimore, Maryland, 21201. Tel: 1-4103286957; Fax: 1-4103288851.E-mail: [email protected]
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Abstract

Background:

Guaiac stool testing has been routinely used as a method to detect gastrointestinal complications in infants with critical congenital heart disease (CHD); however, the sensitivity and specificity have not been established.

Methods:

A retrospective chart review was performed investigating the presence of heme-positive stools and subsequent gastrointestinal complications as well as time to goal caloric intake and radiograph exposure.

Results:

The presence of heme-positive stools was not a statistically significant factor in patients with critical CHD that experienced gastrointestinal complications. Additionally, patients with heme-positive stools did undergo more abdominal X-rays than those with heme-negative stools.

Conclusions:

The routine use of guaiac stool testing in infants with critical CHD is not a predictor of possible gastrointestinal complications and leads to more radiograph exposure for the patient. Close clinical monitoring can be used to evaluate feeding tolerance in infants with critical CHD.

Keywords

Necrotising enterocolitiscongenital heart diseaseguaiac stools
Type
Original Article
Information
Cardiology in the Young , Volume 29 , Issue 5 , May 2019 , pp. 655 - 659
Copyright
© Cambridge University Press 2019 

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References

Golbus, JR, Wojcik, BM, Charpie, JR, Hirsch, JC. Feeding complications in hypoplastic left heart syndrome after the Norwood procedure: a systematic review of the literature. Pediatr Cardiol 2011; 32: 539–552. doi: 10.1007/s00246-011-9907-x.CrossRefGoogle ScholarPubMed
Jeffries, HE, Wells, WJ, Starnes, VA, Wetzel, RC, Moromisato, DY. Gastrointestinal morbidity after norwood palliation for hypoplastic left heart syndrome. Ann Thorac Surg 2006; 81: 982–987. doi: 10.1016/j.athoracsur.2005.09.001.CrossRefGoogle ScholarPubMed
Giannone, PJ, Luce, WA, Nankervis, CA, Hoffman, TM, Wold, LE. Necrotizing enterocolitis in neonates with congenital heart disease. Life Sci 2008; 82: 341–347. doi: 10.1016/j.lfs.2007.09.036.CrossRefGoogle ScholarPubMed
McElhinney, DB, Hedrick, HL, Bush, DM, et al. Necrotizing enterocolitis in neonates with congenital heart disease: risk factors and outcomes. Pediatrics 2000; 106: 1080–1087. doi: 10.1542/peds.106.5.1080.CrossRefGoogle ScholarPubMed
Ostlie, DJ, Spilde, TL, St Peter, SD, et al. Necrotizing enterocolitis in full-term infants. J Pediatr Surg 2003; 38: 1039–1042. doi: 10.1016/S0022-3468(03)00187-8.CrossRefGoogle ScholarPubMed
Hunter, CJ, Podd, B, Ford, HR, Camerini, V. Evidence vs experience in neonatal practices in necrotizing enterocolitis. J Perinatol 2008; 28: S9–S13. doi: 10.1038/jp.2008.43.CrossRefGoogle ScholarPubMed
Pai, AK, Fox, VL. Gastrointestinal bleeding and management. Pediatr Clin 2017; 64: 543–561. doi: 10.1016/j.pcl.2017.01.014.Google ScholarPubMed
Sharma, R, Hudak, ML. A clinical perspective of necrotizing enterocolitis: past, present, and future. Clin Perinatol 2013; 40: 27–51. doi: 10.1016/j.clp.2012.12.012.CrossRefGoogle ScholarPubMed
Boyle, JT. Gastrointestinal bleeding in infants and children. Pediatr Rev 2008; 29: 39–52. doi: 10.1542/pir.29-2-39.CrossRefGoogle ScholarPubMed
Pickering, A, White, R, Davis, NL. Routine fecal occult blood testing does not predict necrotizing enterocolitis in very low birth weight neonates. J Neonatal Perinatal Med 2016; 9: 171–178. doi: 10.3233/NPM-16915120.CrossRefGoogle Scholar
Pinheiro, JMB, Clark, DA, Benjamin, KG. A critical analysis of the routine testing of newborn stools for occult blood and reducing substances. Adv Neonatal Care 2003; 3: 133–138. doi: 10.1016/S1536-0903(03)00073-0.CrossRefGoogle ScholarPubMed
Abramo, TJ, Evans, JS, Kokomoor, FW, Kantak, AD. Occult blood in stools and necrotizing enterocolitis: is there a relationship? Am J Dis Child 1988; 142: 451–452. doi: 10.1001/archpedi.1988.02150040105030.CrossRefGoogle ScholarPubMed
Krishnamurthy, S, Gupta, P, Debnath, S, Gomber, S. Slow versus rapid enteral feeding advancement in preterm newborn infants 1000-1499 g: a randomized controlled trial. Acta Paediatr Int J Paediatr 2010; 99: 42–46. doi: 10.1111/j.1651-2227.2009.01519.x.CrossRefGoogle Scholar
Caple, J, Armentrout, D, Huseby, V, et al. Randomized, controlled trial of slow versus rapid feeding volume advancement in preterm infants. Pediatrics 2004; 114: 1597–1600. http://pediatrics.aappublications.org/content/114/6/1597.abstract.CrossRefGoogle ScholarPubMed
Stiles, AD, Simpson, B, Vaughn, R, Thullen, JT. Incidence of heme positive stools in a neonatal intensive care unit. Pediatr Res 1984; 18: 350A. doi: 10.1203/00006450-198404001-01542.CrossRefGoogle Scholar
Baird, R, Tessier, R, Guilbault, M-P, Puligandla, P, Saint-Martin, C. Imaging, radiation exposure, and attributable cancer risk for neonates with necrotizing enterocolitis. J Pediatr Surg 2013; 48: 1000–1005. doi: 10.1016/j.jpedsurg.2013.02.016.CrossRefGoogle ScholarPubMed
Carter, BM. Nursing assessment of guaiac-positive and occult blood in preterm infant stools. Neonatal Netw J Neonatal Nurs 2014; 33: 101–105. doi: 10.1891/0730-0832.33.2.101.CrossRefGoogle ScholarPubMed