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Variation in feeding practices following the Norwood procedure.
Lambert, Linda M; Pike, Nancy A; Medoff-Cooper, Barbara; Zak, Victor; Pemberton, Victoria L; Young-Borkowski, Lisa; Clabby, Martha L; Nelson, Kathryn N; Ohye, Richard G; Trainor, Bethany; Uzark, Karen; Rudd, Nancy; Bannister, Louise; Korsin, Rosalind; Cooper, David S; Pizarro, Christian; Zyblewski, Sinai C; Bartle, Bronwyn H; Williams, Richard V.
Afiliação
  • Lambert LM; Primary Children's Medical Center, Salt Lake City, UT. Electronic address: Linda.lambert@imail.org.
  • Pike NA; University of California, Los Angeles, CA.
  • Medoff-Cooper B; University of Pennsylvania, School of Nursing, Children's Hospital of Philadelphia, Philadelphia, PA.
  • Zak V; New England Research Institutes, Watertown, MA.
  • Pemberton VL; National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, MD.
  • Young-Borkowski L; Medical College of Wisconsin, Children's Hospital of Wisconsin, Milwaukee, WI.
  • Clabby ML; Emory University, Children's Healthcare of Atlanta, Atlanta, GA.
  • Nelson KN; University of Michigan, C. S. Mott Children's Hospital Congenital Heart Center, Ann Arbor, MI.
  • Ohye RG; University of Michigan School of Medicine, C. S. Mott Children's Hospital Congenital Heart Center, Ann Arbor, MI.
  • Trainor B; Boston Children's Hospital, Boston, MA.
  • Uzark K; Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
  • Rudd N; Medical College of Wisconsin, Children's Hospital of Wisconsin, Milwaukee, WI.
  • Bannister L; The Hospital for Sick Children, Toronto, Ontario, Canada.
  • Korsin R; Columbia University, New York, NY.
  • Cooper DS; Congenital Heart Institute of Florida, Orlando, FL.
  • Pizarro C; Nemours Cardiac Center, Alfred I. duPont Hospital for Children, Wilmington, DE.
  • Zyblewski SC; Medical University of South Carolina, Charleston, SC.
  • Bartle BH; Duke University, Durham, NC.
  • Williams RV; University of Utah School of Medicine, Salt Lake City, UT.
J Pediatr ; 164(2): 237-42.e1, 2014 Feb.
Article em En | MEDLINE | ID: mdl-24210923
OBJECTIVES: To assess variation in feeding practice at hospital discharge after the Norwood procedure, factors associated with tube feeding, and associations among site, feeding mode, and growth before stage II. STUDY DESIGN: From May 2005 to July 2008, 555 subjects from 15 centers were enrolled in the Pediatric Heart Network Single Ventricle Reconstruction Trial; 432 survivors with feeding data at hospital discharge after the Norwood procedure were analyzed. RESULTS: Demographic and clinical variables were compared among 4 feeding modes: oral only (n = 140), oral/tube (n = 195), nasogastric tube (N-tube) only (n = 40), and gastrostomy tube (G-tube) only (n = 57). There was significant variation in feeding mode among sites (oral only 0%-81% and G-tube only 0%-56%, P < .01). After adjusting for site, multivariable modeling showed G-tube feeding at discharge was associated with longer hospitalization, and N-tube feeding was associated with greater number of discharge medications (R(2) = 0.65, P < .01). After adjusting for site, mean pre-stage II weight-for-age z-score was significantly higher in the oral-only group (-1.4) vs the N-tube-only (-2.2) and G-tube-only (-2.1) groups (P = .04 and .02, respectively). CONCLUSIONS: Feeding mode at hospital discharge after the Norwood procedure varied among sites. Prolonged hospitalization and greater number of medications at the time of discharge were associated with tube feeding. Infants exclusively fed orally had a higher weight-for-age z score pre-stage II than those fed exclusively by tube. Exploring strategies to prevent morbidities and promote oral feeding in this highest risk population is warranted.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Gastrostomia / Nutrição Enteral / Síndrome do Coração Esquerdo Hipoplásico / Procedimentos de Norwood Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Female / Humans / Male / Newborn Idioma: En Revista: J Pediatr Ano de publicação: 2014 Tipo de documento: Article País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Gastrostomia / Nutrição Enteral / Síndrome do Coração Esquerdo Hipoplásico / Procedimentos de Norwood Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Female / Humans / Male / Newborn Idioma: En Revista: J Pediatr Ano de publicação: 2014 Tipo de documento: Article País de publicação: Estados Unidos