Feasibility of initiating early enteral nutrition after congenital heart surgery in neonates and infants.

OBJECTIVE

To assess the feasibility of initiating enteral nutrition support with first 24 h of congenital heart repairs in neonates and Infants and its impact on outcomes following surgery.

DESIGN

It is a prospective randomized control single blind study.

SETTING

It is a single centre prospective study carried out in a tertiary care centre at Pediatric cardiac intensive care unit.

PATIENTS

All patients with the cyanotic congenital heart disease with increase pulmonary blood flow, weighing less than 5 kg and undergoing congenital heart repair during the study period were included in the study. Patients with single ventricle status, those undergoing palliative procedures (PA band), open chest, requiring ECMO before leaving operating room, having any other contraindication for starting enteral feeding or those who refuse for consent were excluded from study.

INTERVENTIONS

The patients were randomized into two groups. Group 1 received trophic feeds (10-20 ml/kg/day) starting 4-6 h after surgery while feeds children in group 2 were kept NPO and received feeds after 48 h after surgery.

MEASUREMENTS AND MAIN RESULTS

15 children enrolled in both the groups. Both pre-operative and intraoperative variables were comparable in both the groups. There was no complication (vomiting, diarrhea, NEC, bowel necrosis) noted in the children who received feeds after surgery. Mean duration of mechanical ventilation in the feeds group was 58.2 ± 4.71 h, which was less then significantly less than those in the NPO group (P value 0.05). Similarly, duration of ICU stay was only 179.04 ± 41.28 h in feeds group as compared to 228.72 ± 85.44 h in the NPO group.

CONCLUSIONS

Neonates and Infants tolerate feeds immediately following congenital heart repairs. Moreover, feeds appear to decrease duration of mechanical ventilation and duration of ICU stay.