Miller-Tate Holly, Stewart Jamie, Allen Robin, Husain Nazia, Rosen Kerry, Cheatham John P, Galantowicz Mark, Cua Clifford L
Heart Center, Nationwide Children's Hospital, Columbus, OH 43205, USA.
Congenit Heart Dis. 2013 May-Jun;8(3):228-33. doi: 10.1111/chd.12007. Epub 2012 Sep 25.
Weight gain during the interstage (IS) period for hypoplastic left heart (HLHS) patients has been associated with improved outcomes. IS home monitoring has been shown to improve mortality. No data exist on IS weight gain and home monitoring effects on weight gain for HLHS patients undergoing the hybrid procedure.
Goal of this study was to describe the weight gain of patients with HLHS undergoing the hybrid procedure during the IS period, to determine if weight parameters were associated with mortality, and to determine if home monitoring improved weight gain.
Retrospective review was performed. Patients were included if they had the diagnosis of HLHS and underwent hybrid procedure. Baseline demographics, surgical dates, and all IS weights were recorded.
Forty-four patients met inclusion criteria, 24 patients had IS monitoring. Time period evaluated was from April 2006 to June 2011. Mean birth weight of the total population was 3.13 ± 0.61 kg, age at hybrid was 5.84 ± 4.10 days, weight z-score at hybrid discharge was -1.66 ± 1.01, age at pre-Stage II was 6.12 ± 1.37 months, IS weight gain was 16.85 ± 5.94 g/day, and weight z-score pre-Stage II was -2.25 ± 1.28. Monitored patients had significantly higher weight z-score pre-Stage II (-1.67 ± 0.98 vs. -2.82 ± 1.28) and lower change in weight z-score (-0.26 ± 0.97 vs. -1.24 ± 1.06). Eight patients died IS. There was a significant difference in weight gain per day in those that survived the IS period (17.87 ± 4.75 g/day vs. 12.28 ± 8.65 g/day). There were no significant differences in weight characteristics in patients that survived the Stage II procedure (n = 28) vs. those that did not (n = 7).
Home monitoring improved IS weight gain in patients undergoing the hybrid procedure. Decreased weight gain per day was associated with IS mortality.
左心发育不全综合征（HLHS）患者在过渡期（IS）体重增加与预后改善相关。已证明IS期家庭监测可降低死亡率。目前尚无关于接受杂交手术的HLHS患者IS期体重增加及家庭监测对体重增加影响的数据。
本研究的目的是描述接受杂交手术的HLHS患者在IS期的体重增加情况，确定体重参数是否与死亡率相关，并确定家庭监测是否能改善体重增加。
进行回顾性研究。纳入诊断为HLHS并接受杂交手术的患者。记录基线人口统计学资料、手术日期和所有IS期体重。
44例患者符合纳入标准，24例患者接受了IS期监测。评估时间段为2006年4月至2011年6月。总体人群的平均出生体重为3.13±0.61kg，杂交手术时年龄为5.84±4.10天，杂交手术后出院时体重Z评分-1.66±1.01，II期前年龄为6.12±1.37个月，IS期体重增加为16.85±5.94g/天，II期前体重Z评分为-2.25±1.28。接受监测的患者II期前体重Z评分显著更高（-1.67±0.98对-2.82±1.28），体重Z评分变化更低（-0.26±0.97对-1.24±1.06）。8例患者在IS期死亡。IS期存活患者的每日体重增加有显著差异（17.87±4.75g/天对12.28±8.65g/天）。接受II期手术存活的患者（n=28）与未存活的患者（n=7）在体重特征上无显著差异。
家庭监测改善了接受杂交手术患者的IS期体重增加。每日体重增加减少与IS期死亡率相关。
