Holst Line Marie, Serrano Faridis, Shekerdemian Lara, Ravn Hanne Berg, Guffey Danielle, Ghanayem Nancy S, Monteiro Sonia
Department of Cardiothoracic Anaesthesiology, Copenhagen University Hospital, Copenhagen, Denmark.
Section of Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas.
Congenit Heart Dis. 2019 Nov;14(6):1207-1213. doi: 10.1111/chd.12827. Epub 2019 Aug 2.
To investigate the impact of feeding mode on neurodevelopmental outcomes in children with congenital heart defects.
A retrospective cohort study of 208 children with congenital heart disease (CHD), who had surgery from 1 January 2013 until 31 December 2016 at Texas Children's Hospital, Houston, TX, US.
University Hospital, Developmental Outcome Clinic.
Standardized cognitive scores were assessed with Capute Scales and motor development with Revised Gesell Developmental Schedules. We analyzed anthropometrics, mode of feeding, surgical complexity, syndrome, and gender as predictors of developmental outcomes at four time points: hospital discharge, and 6, 12, and 24 months of age.
Mode of feeding is associated with neurodevelopmental outcome in children with CHD. Children on enteral feeding tubes had significantly lower developmental quotient (DQ) scores in cognition, communication, and motor function at 12 and 24 months compared to orally fed children. There were greater proportions of developmental delays (DQ < 70) in enteral tube fed children at the 6, 12, and 24 months visits. Further, there was a strong association between presence of enteral feeding tube, syndrome, and developmental outcome. Greater surgical complexity, weight gain and ethnicity were not associated with the developmental outcomes.
Our findings suggest that the presence of an enteral feeding tube following corrective congenital heart surgery are at increased risk of neurodevelopmental delays at 12 and 24 months.
探讨喂养方式对先天性心脏病患儿神经发育结局的影响。
对208例先天性心脏病（CHD）患儿进行回顾性队列研究，这些患儿于2013年1月1日至2016年12月31日在美国得克萨斯州休斯敦的德克萨斯儿童医院接受手术。
大学医院发育结局诊所。
使用卡普特量表评估标准化认知得分，使用修订版格塞尔发育量表评估运动发育。我们分析了人体测量学、喂养方式、手术复杂性、综合征和性别，作为四个时间点（出院时以及6、12和24月龄）发育结局的预测因素。
喂养方式与先天性心脏病患儿的神经发育结局相关。与经口喂养的儿童相比，接受肠内喂养管的儿童在12个月和24个月时的认知、沟通和运动功能发育商（DQ）得分显著更低。在6、12和24个月的随访中，接受肠内喂养管的儿童发育迟缓（DQ<70）的比例更高。此外，肠内喂养管的存在、综合征与发育结局之间存在密切关联。更高的手术复杂性、体重增加和种族与发育结局无关。
我们的研究结果表明，先天性心脏病矫正手术后使用肠内喂养管的患儿在12个月和24个月时发生神经发育迟缓的风险增加。
