Early enteral nutritional support on nutrition assessments and clinical outcomes of congenital heart disease postoperation

Abstract

Objective To investigate the effect and feasibility of early enteral nutrition support on postoperative nutrition assessments and clinical outcomes in children patients with congenital heart disease. Methods From October 2013 to October 2014, a number of 100 cases congenital heart disease aged six months to two years old were treated with early enteral nutrition support after operation. According to gender, fifty patients were randomly divided into the intervened group, who were treated with the early enteral nutrition support program. The other fifty patients were divided into control group with no nutrition support. The detailed early enteral nutrition support project were(a) withdraw breathing machine at the same day, giving enteral nutrition 6 hours later after postoperation; (b) patients assist with long-term breathing machine, giving enteral nutrition 12-24 hours later after postoperation. The age, heigth, weight, serum C- reactive protein(CRP), serum retinoic binding protein(RBP), serum prealbumin( Pre-ALB) were recorded before operation. Seven days after operation, above indicators were observed again. In addition, the first time of excrete, the number of feeding interruption, the time of feeding, the time of ventilator, and the related complications were also recorded at hospitalization period. Results No difference of basic information and accompanying complications were observed between control and nutritional intervention group. As to nutritional status, weight-for-age z-score(WAZ) were significant higher in the nutritional intervention group than the control group(-0.22±1.16 vs. 0.73±1.29, P=0.019) after operation. However length/height-for-age z-score(LAZ/HAZ) and weight-for-length/height z-score(WLZ/WHZ) were similar between control and nutritional intervention group whatever pre-operation and postoperation. Preoperative CRP, RBP, and Pre-ALB were no significant difference between early enteral nutrition and control group. After operation CRP levels in the early enteral nutrition group were significantly lower than that of control group[(45.2±16.2)mg/L vs.(67.3±35.5)mg/L, P 0.05). Conclusion Early nutritional intervention can help gastrointestinal function, enhance nutritional status, lower serum CRP levels and increased serum RBP and Pre-ALB concentrations. It did not add ICU time and ventilation time. Key words: Congenital heart disease; Enteral nutritional; Nutritional status; Clinical outcome