Abstract Objective To study the effect of different energy feeding patterns on the nutritional status, clinical course, and outcome of children with congenital heart disease (CHD) and severe pneumonia. Methods A total of 43 malnourished infants, aged <6 months, who were diagnosed with ventricular septal defect and severe pneumonia and underwent surgical operation from January 1 to December 30, 2017 were enrolled. They were randomly divided into an observation group with 21 infants and a control group with 22 infants. The infants in the observation group were given calorie-enriched formula milk powder (100 kcal/100 mL) after surgery, and those in the control group were given formula milk powder with normal calories (67 kcal/100 mL). The two groups were observed for 3 months to record physical measurements, laboratory markers and nutritional risk screening results. Nutritional status was evaluated for all infants. The two groups were compared in terms of prognosis and adverse events. Results There were no significant differences between the two groups in physical measurements, laboratory markers, nutritional assessment and nutritional risk screening results on admission (P > 0.05). At discharge and 1 and 3 months after surgery, the control group had significantly higher degree of malnutrition and level of nutritional risk than the observation group (P < 0.05). The analysis of variance with repeated measures showed significant differences in body weight, upper arm circumference, weight-forage Z-score, height-for-age Z-score, weight-for-height Z-score, and albumin level at different time points and between different groups, and there was an interaction between group factors and time factors (P < 0.05). Compared with the control group, the observation group had a significantly lower average daily intake of fluid, a significantly higher average daily intake of energy, and a significantly lower incidence rate of insufficient feeding during hospitalization (P < 0.05). Compared with the control group, the observation group had significantly shorter length of hospital stay, duration of mechanical ventilation, and duration of postoperative pyrexia, as well as significantly lower hospital costs (P < 0.05). No significant adverse reactions were observed in either group. Conclusions An appropriate increase in postoperative energy supply for children with CHD can improve the status of malnutrition and clinical outcome.
HUANG Jiao-Tian,LU Xiu-Lan,XIAO Zheng-Hui et al. Clinical effect of feeding with calorie-enriched formula in children with ventricular septal defect and severe pneumonia[J]. CJCP, 2019, 21(10): 998-1004.
HUANG Jiao-Tian,LU Xiu-Lan,XIAO Zheng-Hui et al. Clinical effect of feeding with calorie-enriched formula in children with ventricular septal defect and severe pneumonia[J]. CJCP, 2019, 21(10): 998-1004.
GBD 2015 LRI Collaborators. Estimates of the global, regional, and national morbidity, mortality, and aetiologies of lower respiratory tract infections in 195 countries:a systematic analysis for the Global Burden of Disease Study 2015[J]. Lancet Infect Dis, 2017, 17(11):1133-1161.
[2]
Arodiwen I, Chinawa J, Ujunwa F, et al. Nutritional status of congenital heart disease (CHD) patients:burden and determinant of malnutrition at university of Nigeria teaching hospital Ituku-Ozalla, Enugu[J]. Pak J Med Sci, 2015, 31(5):1140-1145.
[3]
Medoff-Cooper B, Ravishankar C. Nutrition and growth in congenital heart disease:a challenge in children[J]. Curr Opin Cardiol, 2013, 28(2):122-129.
Hulst JM, Zwart H, Hop WC, et al. Dutch national survey to test the STRONGkids nutritional risk screening tool in hospitalized children[J]. Clin Nutr, 2010, 29(1):106-111.
De Wit B, Meyer R, Desai A, et al. Challenge of predicting resting energy expenditure in children undergoing surgery for congenital heart disease[J]. Pediatr Crit Care Med, 2010, 11(4):496-501.
Nicholson GT, Clabby ML, Kanter KR, et al. Caloric intake during the perioperative period and growth failure in infants with congenital heart disease[J]. Pediatr Cardiol, 2013, 34(2):316-321.
[15]
Radman M, Mack R, Barnoya J, et al. The effect of preoperative nutritional status on postoperative outcomes in children undergoing surgery for congenital heart defects in San Francisco (UCSF) and Guatemala City (UNICAR)[J]. J Thorac Cardiovasc Surg, 2014, 147(1):442-450.
[16]
Fitria L, Caesa P, Joe J, et al. Did malnutrition affect postoperative somatic growth in pediatric patients undergoing surgical procedures for congenital heart disease?[J]. Pediatr Cardiol, 2019, 40(2):431-436.
[17]
Toole BJ, Toole LE, Kyle UG, et al. Perioperative nutritional support and malnutrition in infants and children with congenital heart disease[J]. Congenit Heart Dis, 2014, 9(1):15-25.
[18]
Medoff-Cooper B, Ravishankar C. Nutrition and growth in congenital heart disease:a challenge in children[J]. Curr Opin Cardiol, 2013, 28(2):122-129.
[19]
Hulst JM, Zwart H, Hop WC, et al. Dutch national survey to test the STRONGkids nutritional risk screening tool in hospitalized children[J]. Clin Nutr, 2010, 29(1):106-111.
[20]
Blasquez A, Clouzeau H, Fayon M, et al. Evaluation of nutritional status and support in children with congenital heart disease[J]. Eur J Clin Nutr, 2016, 70(4):528-531.
[21]
Medoff-Copper B, Ravishankar C. Nutrition and growth in congenital heart disease:a challenge in children[J]. Curr Opin Cardiol, 2013, 28(2):122-129.
[22]
Monteiro FP, de Araujo TL, Lopes MV, et al. Nutritional status of children with congenital heart disease[J]. Rev Lat Am Enfermagem, 2012, 20(6):1024-1032.
El-Koofy N, Mahmoud AM, Fattouh AM. Nutritional rehabilitation for children with congenital heart disease with left to right shunt[J]. Turk J Pediatr, 2017, 59(4):442-451.
Newcombe J, Fry-Bowers E. a post-operative feeding protocol to improve outcomes for neonates with critical congenital heart disease[J]. J Pediatr Nurs, 2017, 35:139-143.
ZHANG Ji-Yong, ZHOU Shao-Ming, WANG Shao-Hua, SUI Feng-Xuan, GAO Wu-Hong, LIU Qing, CAI Hua-Bo, JIANG Hong-Ying, LI Wei-Yan, WANG Li-Ting, LI Li, ZHAO Wei, YING Jing, WU Qian-Zhen, WENG Bi-Xia, ZENG Yong-Mei. Risk factors for cow's milk protein allergy in infants: a multicenter survey[J]. CJCP, 2020, 22(1): 42-46.
