Enteral feeding and caloric intake in neonates after cardiac surgery.
BACKGROUND
Adequate enteral nutrition may be difficult to achieve early in neonates after cardiac surgery, but it is essential for growth, wound healing, and immune function.


OBJECTIVE
To assess caloric intake in neonates receiving enteral nutrition after surgery.


METHODS
A retrospective chart review was conducted of daily enteral caloric intake in the cardiac intensive care unit of a tertiary children's hospital. Data on the institution of enteral feeding and the discontinuation of parenteral nutrition were assessed for full-term neonates who had undergone cardiac surgery.


RESULTS
Caloric intake was assessed in 100 patients, 52 with biventricular cardiac defects and 48 with a functional single ventricle. The median duration of stay in the cardiac intensive care unit was 13 days (range, 4-69), and patients received enteral feeding exclusively for a median of 5 days (range, 1-43). In total, 705 patient days were evaluated. The median caloric intake per day was 93 kcal/kg (range, 43-142). A goal of 100 kcal/kg was achieved for 48.4% of patient days and 120 kcal/kg for only 19.7% of patient days. Median weight change for the period of enteral feeding was -20 g (range, -775 to 1485 g).


CONCLUSIONS
Enteral feeding alone is often suboptimal after neonatal cardiac surgery. New strategies to improve caloric intake may enhance postoperative recovery.
Schwalbe-Terilli
Courtney R
CR
Department of Pediatrics, The Children's Hospital of Philadelphia, The University of Pennsylvania School of Medicine, PA, USA. cschwalbe@hotmail.com
Hartman
Diane H
DH
Nagle
Monica L
ML
Gallagher
Paul R
PR
Ittenbach
Richard F
RF
Burnham
Nancy B
NB
Gaynor
J William
JW
Ravishankar
Chitra
C
D002315:Cardiopulmonary Bypass / Q000009:adverse effects / Q000379:methods*; D002149:Energy Intake; D004750:Enteral Nutrition; D005260:Female; D006330:Heart Defects, Congenital / Q000378:metabolism / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal / Q000379:methods*; D008297:Male; D012189:Retrospective Studies