title: Rapid advancement to more concentrated formula in infants after surgery for congenital heart disease reduces duration of hospital stay: a randomized clinical trial.
abstract: OBJECTIVE
  To determine the impact of rapid advancement to more concentrated formula on weight gain and duration of hospitalization for infants after cardiac surgery.
  
  
  METHODS
  We performed a double-blinded, randomized trial of rapid advancement to higher achieved formula concentration for postoperative infants younger than 1 year of age. After transfer to the inpatient ward from the critical care unit, infants were randomly assigned to rapid advancement to a higher achieved formula concentration (2-day transition) or usual care (5-day transition, lower concentration target).
  
  
  RESULTS
  The adequacy of energy intake (expressed as the median percentage of the estimated energy requirement) before discharge from the hospital was 98% in the intervention versus 78% in the usual care group ( P = .01). Before discharge, the median rate of weight gain was greater in the rapid advancement (20 g/d) versus the usual care group (loss of 35 g/d, P < .03). The median postoperative duration of stay on the cardiology inpatient unit was 5 days for the intervention versus 6 days for the usual care group ( P < .05).
  
  
  CONCLUSIONS
  Rapid advancement to higher achieved formula concentration significantly improved energy intake and weight gain and decreased duration of postoperative hospital stay in infants after cardiac surgery.
authors.affiliation: Divisions of Cardiology and Gastroenterology, Department of Pediatrics, University of Toronto, The Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Francy
authors.initials: F
authors.lastname: Pillo-Blocka
authors.forename: Ian
authors.initials: I
authors.lastname: Adatia
authors.forename: Waseem
authors.initials: W
authors.lastname: Sharieff
authors.forename: Brian W
authors.initials: BW
authors.lastname: McCrindle
authors.forename: Stanley
authors.initials: S
authors.lastname: Zlotkin
mesh_terms: D004311:Double-Blind Method; D002149:Energy Intake; D006330:Heart Defects, Congenital / Q000601:surgery; D006801:Humans; D007223:Infant; D007225:Infant Food; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D007902:Length of Stay; D011182:Postoperative Care; D011184:Postoperative Period; D015430:Weight Gain