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Poor Weight Recovery Between Stage 1 Palliation and Hospital Discharge for Infants with Single Ventricle Physiology: An Analysis of the National Pediatric Cardiology Quality Improvement Collaborative Phase II Dataset.
Moza, Rohin; Truong, Dongngan T; Lambert, Linda M; Ou, Zhining; Amula, Venugopal; Eckhauser, Aaron; Minich, L LuAnn; Williams, Richard V.
Afiliação
  • Moza R; Division of Cardiology, Department of Pediatrics, University of Utah and Primary Children's Hospital, Salt Lake City, UT. Electronic address: rohin.moza@hsc.utah.edu.
  • Truong DT; Division of Cardiology, Department of Pediatrics, University of Utah and Primary Children's Hospital, Salt Lake City, UT.
  • Lambert LM; Division of Cardiology, Department of Pediatrics, University of Utah and Primary Children's Hospital, Salt Lake City, UT.
  • Ou Z; Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT.
  • Amula V; Division of Critical Care Medicine, Department of Pediatrics, University of Utah and Primary Children's Hospital, Salt Lake City, UT.
  • Eckhauser A; Division of Cardiothoracic Surgery, Department of Surgery, University of Utah and Primary Children's Hospital, Salt Lake City, UT.
  • Minich LL; Division of Cardiology, Department of Pediatrics, University of Utah and Primary Children's Hospital, Salt Lake City, UT.
  • Williams RV; Division of Cardiology, Department of Pediatrics, University of Utah and Primary Children's Hospital, Salt Lake City, UT.
J Pediatr ; 234: 20-26.e2, 2021 Jul.
Article em En | MEDLINE | ID: mdl-33774055
OBJECTIVE: To investigate change in weight-for-age z-scores (WAZ) and risk factors for impaired weight gain between stage 1 palliation (S1P) for single ventricle physiology and discharge. STUDY DESIGN: This was a secondary analysis of the National Pediatric Cardiology Quality Improvement Collaborative Phase II database. The primary outcome was change in WAZ between S1P and discharge. Risk factors were selected using multivariable mixed effects regression constructed by step-wise model selection, with adjustment for WAZ at S1P and a random effect for center. RESULTS: Of 730 infants who were discharged after S1P, WAZ decreased in 98.6% (-1.5 ± 0.7). WAZ at discharge was <-1 but >-2 (at risk) in 40% and <-2 (failure to thrive) in 35% of participants. Males, higher WAZ at S1P, non-S1P procedures (mostly noncardiac), increased length of stay, necrotizing enterocolitis, and angiotensin-converting enzyme inhibitor use at discharge were associated with a greater decrease in WAZ. Preoperative enteral feeding and respiratory medications were associated with a lesser decrease in the WAZ. CONCLUSIONS: Nearly all infants lose weight after S1P with little recovery by hospital discharge. At discharge, three-quarters of the infants in the cohort were at risk for impaired weight gain or had failure to thrive. Most risk factors associated with change in WAZ were unmodifiable or surrogates of disease severity. Novel interventions are needed to minimize the early catabolic effects and promote anabolic recovery after S1P.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Cuidados Paliativos / Complicações Pós-Operatórias / Síndrome do Coração Esquerdo Hipoplásico / Insuficiência de Crescimento / Coração Univentricular Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Female / Humans / Infant / Male / Newborn Idioma: En Revista: J Pediatr Ano de publicação: 2021 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: Cuidados Paliativos / Complicações Pós-Operatórias / Síndrome do Coração Esquerdo Hipoplásico / Insuficiência de Crescimento / Coração Univentricular Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Female / Humans / Infant / Male / Newborn Idioma: En Revista: J Pediatr Ano de publicação: 2021 Tipo de documento: Article País de publicação: Estados Unidos