Feeding Practices and Outcomes of Infants Undergoing the Norwood Procedure

Abstract

Objective. To determine if early pre- and postoperative enteral feeding was associated with improved postoperative outcomes in infants with hypoplastic left heart syndrome undergoing the Norwood procedure. Study Design. Retrospective chart review of infants undergoing stage 1 surgical palliation for hypoplastic left heart syndrome. Results. Baseline demographics were similar between infants who received preoperative enteral nutrition (n = 17) and those who did not (n = 23). Infants who received no enteral nutrition had higher preoperative serum lactate levels (3.7 ± 2.1 vs 2.5 ± 0.8 mmol/L, P = .02). Postoperative length of stay, days of parenteral nutrition, and progression of enteral nutrition did not differ between groups. Postoperative length of stay was positively correlated with postoperative number of days from first to full enteral nutrition (r = .6; P < .0005) and day at full enteral nutrition (r = .6; P < .0005) but not day of first enteral nutrition (r = .15; P = .382). Conclusion. While current evidence indicates benefit of early enteral feeding, no association was found between preoperative enteral nutrition and postoperative outcomes measured. Further research using feeding algorithms may help inform care of these complex infants.