Enteral feeding abilities of neonates with congenital heart diseases underwent cardiac surgery — analysis of opportunities

Abstract

Objective: to analyze the factors affecting enteral feeding ability of neonates with congenital heart defects (CHD) who underwent cardiac surgery.Patients and methods. The study included 214 full-term newborns with CHD who underwent cardiac surgery: 63 children with palliative correction of CHD and 151 children with radical correction of CHD. The characteristics of the early postoperative period, the timing of bottle feeding with additional gavage feeding, the achievement of the full volume of bottle feeding, the incidence of breastfeeding after surgery, and the duration of hospitalization were analyzed.Results. The use of cardiopulmonary bypass (CPB) was associated with a longer duration of mechanical ventilation and inotropic therapy after cardiac surgery. Positive correlations (r > 0.6) were revealed between the duration of mechanical ventilation, inotropic therapy, of stay in the intensive care unit and the timing of the bottle feeding ability (including without additional gavage feeding). Newborns with palliative correction were able to feed from bottle significantly later than children with radical correction: there was a higher frequency of supplementary gavage feeding by the time of discharge (15.7 % vs. 1.8 %, p = 0.0016), a longer length of stay in hospital. Children who underwent the Norwood procedure were able to bottle feeding significantly later than newborns after other types of surgery.Conclusion. Newborns with CHD require a personalized approach to enteral feeding, depending on the types of cardiac surgery undergone. Factors influencing the feeding of newborns were the use of CPB, the duration of mechanical ventilation and inotropic therapy after surgery.