Anderson Jeffrey B, Marino Bradley S, Irving Sharon Y, García-España J Felipe, Ravishankar Chitra, Stallings Virginia A, Medoff-Cooper Barbara
Division of Cardiology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45255, USA.
Cardiol Young. 2011 Aug;21(4):421-9. doi: 10.1017/S1047951111000229. Epub 2011 Mar 9.
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 methodsFull-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.
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.
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.
充足的营养支持对于婴儿的正常生长发育至关重要。已知患有先天性心脏病的婴儿有生长发育迟缓的风险。我们试图描述接受双心室先天性心脏病手术修复的婴儿围手术期的生长情况，并评估其生长模式的预测因素。
材料和方法
在一项大型前瞻性研究之后，对在单一机构接受双心室先天性心脏病手术修复的足月婴儿进行了一项回顾性队列研究。排除患有面部、胃肠道或神经系统异常、三体染色体异常、出生体重低于2500克或在出院前转至另一机构的婴儿。主要结局是从手术到出院时年龄别体重Z评分的变化。我们的次要结局变量是术后住院时间。
共有76名婴儿符合纳入标准。手术时的中位年龄为5天，范围为1至44天。手术时年龄别体重Z评分的中位数为-0.2，范围为-2.9至2.8，出院时降至-1.2，范围为-3.4至1.8。从手术到出院时年龄别体重Z评分的中位数变化为-1.0，范围为-2.3至0.2。术后营养延迟（p<0.001）和术后初次拔管后再次插管（p = 0.001）与年龄别体重Z评分降低相关。
接受双心室先天性心脏病修复的婴儿术后生长不良。早期开始术后营养可能会缓解这种情况。
