title: Enteral feeding in neonates with prostaglandin-dependent congenital cardiac disease: international survey on current trends and variations in practice.
abstract: BACKGROUND
  The benefits of early enteral feeding in neonates are well known and yet the optimal pre-operative nutrition of prostaglandin-dependent infants with congenital cardiac disease remains ill-defined. This survey delineates international nutritional practices and trends with this population.
  
  
  METHODS
  Paediatric practitioners responded to an Internet-based survey that explored assessment of feeding practices, criteria for feeding readiness, medication dosing, concurrent feeding with umbilical catheters, and the observed incidence of feeding intolerance. Documented nutritional strategies were not correlated with patient outcomes.
  
  
  RESULTS
  A total of 200 caregivers responded to the survey. Fewer United States caregivers (56%) reported routine pre-operative enteral feeding in prostaglandin-dependent infants when compared with caregivers outside the United States of America (93%). Of those respondents willing to feed, approximately two-thirds did not base their decision on the ductal flow direction. Numerous and heterogeneous parameters were reported to assess feeding readiness. Many caregivers report scepticism with regard to enteral feeding safety in neonates with an umbilical artery catheter, and to a lesser extent in the presence of an umbilical venous catheter. In summary, there is a prevailing lack of consensus regarding pre-operative enteral nutrition to prostaglandin-dependent neonates.
  
  
  CONCLUSIONS
  This survey demonstrates noticeable variations in pre-operative nutritional practices between providers from around the world. Arguments that support or refute this practice have little support in the medical literature. Future studies should aim to demonstrate the safety of such practice and compare the outcomes of prostaglandin-dependent neonates who were pre-operatively enterally fed with those who were not.
authors.affiliation: Section of Pediatric Cardiac Intensive Care, The Heart Institute, University of Colorado at Denver, Aurora, Colorado, United States of America.
authors.forename: Lisa W
authors.initials: LW
authors.lastname: Howley
authors.forename: Jon
authors.initials: J
authors.lastname: Kaufman
authors.forename: Erica
authors.initials: E
authors.lastname: Wymore
authors.forename: Patti
authors.initials: P
authors.lastname: Thureen
authors.forename: Jeff K
authors.initials: JK
authors.lastname: Magouirk
authors.forename: Bryan
authors.initials: B
authors.lastname: McNair
authors.forename: Eduardo M
authors.initials: EM
authors.lastname: da Cruz
mesh_terms: D004750:Enteral Nutrition / Q000379:methods* / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006330:Heart Defects, Congenital / Q000628:therapy*; D006801:Humans; D007231:Infant, Newborn; D038622:Internationality; D020407:Internet; D016015:Logistic Models; D010372:Pediatrics / Q000379:methods / Q000706:statistics & numerical data*; D011364:Professional Practice / Q000706:statistics & numerical data*; D011453:Prostaglandins / Q000627:therapeutic use; D014481:United States
chemical_list: D011453:Prostaglandins