Cardiovascular Pharmacology: Open Access

Peri-operative feeding approaches in single ventricle infants: A survey of 46 centers

15^th International Conference on Pediatrics and Pediatric Cardiology

February 19-20, 2018 | Paris, France

Elena C Ocampo

Baylor College of Medicine, USA

Posters & Accepted Abstracts: Cardiovasc Pharm Open Access

Abstract:

Background: Feeding dysfunction occurs commonly in infants with single ventricle heart disease and impacts growth and long-term outcomes. Little evidence exists to guide safe feeding in this population. This study surveyed centers participating in the National Pediatric Cardiology Quality Improvement Collaborative to assess prevailing feeding practices among those caring for single ventricle neonates. Methods: Web-based survey of 56 pediatric cardiac surgical centers was conducted. Questions addressed peri-operative feeding approaches and responses were presented and analyzed descriptively. Results: Of 56 centers, 46 (82%) completed a survey. Pre-operative feeding was common in single ventricle infants (30/46; 65%), routes varied. Centers who did not feed infants pre-operatively cited the risk of necrotizing enterocolitis (16/16; 100%), presence of umbilical artery catheter (12/16; 75%), and prostaglandin infusion (9/16; 56%) as main concerns. 67% of centers reported no specific vital sign thresholds for withholding enteral feedings. In the post-operative period, most centers used an internal guideline (21/46; 46%) or an informal practice (15/46; 33%) to determine feeding readiness. Approaches to findings were significantly different among centers. About 40% of centers did not send patients home with feeding tubes, and there was no clear consensus between preferred feeding tube modality at discharge. Conclusion: Considerable variation exists in feeding practices for infants with single ventricle congenital heart disease among 46 centers participating in a quality improvement collaborative. Although most centers generally feed infants pre-operatively, feeding practices remain center-specific. Variability continues in the immediate post-operative and interstage periods. Further opportunities exist for investigation, standardization and development of best-practice feeding guidelines.