Jones Courtney, Winder Melissa, Ou Zhining, Miller Thomas A, Malik Lauren, Flannery Moira, Glotzbach Kristi
Primary Children's Hospital, Acute Care Therapy Services, Intermountain Healthcare, Salt Lake City, UT, USA.
Department of Pediatrics, University of Utah, Salt Lake City, UT, USA.
Cardiol Young. 2022 Apr;32(4):628-635. doi: 10.1017/S1047951121002833. Epub 2021 Jul 26.
The aim of this study was to describe the development and assess the usefulness of a feeding clinic to help infants with CHD tolerate the highest level of oral feeding while achieving growth velocity and supporting neurodevelopment.
This retrospective, cohort study assessed feeding outcomes for infants who underwent cardiac surgery at <30 days of age with cardiopulmonary bypass between February 2016 and April 2020. Diagnoses, age at surgery, hospitalisation variables, and feeding outcomes were compared between two cohorts, pre- and post-implementation of a specialised feeding clinic using Exact Wilcoxon signed-rank test, chi-squared, or Fisher's exact test. The association between time to full oral feed and risk factors was assessed using univariable and multivariable Cox regression model.
Post-clinic infants (n = 116) surgery was performed at a median of 6 days of life (interquartile range: 4, 8) with median hospital length of stay of 19 days (interquartile range: 16, 26). Infants' median age at first clinic visit was at 30 days old (interquartile range: 24, 40) and took median 10 days (interquartile range: 7, 12) after hospital discharge to first clinic visit. In the post-clinic cohort, the median time to 100% oral feeding was 47 days (interquartile range: 27, 96) compared to the 60 days (interquartile range: 20, 84) in the pre-clinic cohort (n = 22), but the difference was not statistically significant.
The cardiac feeding clinic was utilised by our neonatal surgery population and feasible in coordination with cardiology follow-up visits. Future assessment of cardiac feeding clinic impact should include additional measures of feeding and neurodevelopmental success.
本研究旨在描述一家喂养诊所的发展情况，并评估其在帮助患有先天性心脏病（CHD）的婴儿耐受最高水平的经口喂养、实现生长速度以及支持神经发育方面的实用性。
这项回顾性队列研究评估了2016年2月至2020年4月期间在30日龄前接受体外循环心脏手术的婴儿的喂养结果。使用精确威尔科克森符号秩检验、卡方检验或费舍尔精确检验，比较了两个队列（实施专门喂养诊所之前和之后）的诊断、手术年龄、住院变量和喂养结果。使用单变量和多变量Cox回归模型评估完全经口喂养时间与风险因素之间的关联。
诊所设立后队列中的婴儿（n = 116）手术时的中位年龄为出生后6天（四分位间距：4，8），中位住院时间为19天（四分位间距：16，26）。婴儿首次到诊所就诊的中位年龄为30日龄（四分位间距：24，40），出院后到首次诊所就诊的中位时间为10天（四分位间距：7，12）。在诊所设立后队列中，完全经口喂养的中位时间为47天（四分位间距：27，96），而在诊所设立前队列（n = 22）中为60天（四分位间距：20，84），但差异无统计学意义。
我们的新生儿手术人群利用了心脏喂养诊所，并且与心脏病学随访协调可行。未来对心脏喂养诊所影响的评估应包括喂养和神经发育成功的其他衡量指标。
