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Minerva Pediatrics 2022 February;74(1):16-22

DOI: 10.23736/S2724-5276.18.05200-3


language: English

Meeting nutritional needs of infants under 3 months of life within the first week after cardiovascular surgery

Carola SAURE , Belisario ALMEYRA IBARRA, Carolina CAMINITI, Mariela KRYNSKI, Mercedes MONTONATI , Ricardo RODRIGUEZ, María ALTHABE

Department of Pediatric Diabetes and Nutrition, SAMIC Children’s Hospital, Buenos Aires, Argentina

BACKGROUND: After heart surgery requiring cardiopulmonary bypass, neonates have a profound metabolic response to stress. If adequate nutritional support is not provided this leads to loss of lean mass and deterioration of vital organs. The objective of this study was to describe the nutritional status and nutritional support achieved in infants younger than 3 months of life undergo in cardiovascular surgery.
METHODS: A prospective, descriptive study was conducted in a Pediatric Cardiovascular intensive therapy at tertiary care center. All patients younger than 3 months of life admitted to the cardiovascular unit undergoing heart surgery between April 2013 and May2014 were included. We proposed to achieve 67 kcal/kg/day as one of the nutritional intervention goals. The children were evaluated on admission and at 3 and 7 days post-surgery.
RESULTS: Seventy-four patients were evaluated. Total parenteral nutrition could be implemented in all patients that were entered into the protocol requiring parenteral nutrition. Mean volume administered over this period was 50 mL/kg/day (range, 25 to 80 mL/kg/day). Evaluation on admission, at 72 hours, and one week postoperatively showed that 70%, 69%, and 62.7% of the patients, respectively, were not able to achieve the 67 kcal/kg/day proposed as one of the nutritional intervention goals. It was found that at the three study time points enteral and parental caloric intake could cover 100% of the metabolic resting energy expenditure (REE) estimated using the Schofield and WHO equations with no significant differences between the two.
CONCLUSIONS: Although the calorie intake proposed by our intervention was not achieved, it did cover 100% of the REE calculated by the equations.

KEY WORDS: Cardiac surgical procedures; Nutritional status; Newborn infant; Energy metabolism

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