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Nutritional programmes improve outcomes in infants with congenital heart disease

03 Jan 2021

In neonates with congenital heart disease, a multi-interventional nutrition programme improves weight gain, discharge outcomes, and enteral feeding without amplifying the risk of necrotizing enterocolitis (NEC), a recent study reports.

Researchers conducted a single-centre cohort analysis of 570 newborns with congenital heart disease who underwent cardiac surgery. The interventions were delivered in two phases. The first involved a feeding algorithm that optimized initiation and progression of parenteral and enteral nutrition, depending on infant postoperative characteristics.

The second phase involved another algorithm that determined the best use of donor breast milk (DBM) in high-risk infants, and included an assessment plan for oromotor skills.

“The programme’s feeding algorithms,” the researchers explained, “were designed to advance feedings differently in patients deemed high-risk versus low-to-average-risk based on their postoperative cardiac physiology.”

The nutrition programme led to fewer gastrostomy tubes (G-tube) at hospital discharge, down to 12 percent after phase 1, from 25 percent at phase 0. Gains were maintained until phase 2, when 14 percent still had G-tubes attached.

Phase 2 of the intervention likewise increased the number of infants who were able to receive enteral nutrition prior to their cardiac surgery, without exacerbating the risk of NEC. The DBM component of phase 2 also led to a higher percentage of patients receiving DBM or expressed breast milk in both preoperative and postoperative periods.

Important study limitations included its retrospective design, which precluded the ability to draw causal links between factors, as well as potentially unmeasured confounders, the researchers said.

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Most Read Articles
01 Dec 2020
Tetanus toxoid 5 Lf, diphtheria toxoid 2 Lf, pertussis toxoid 2.5 mcg, filamentous haemagglutinin 5 mcg, fimbriae types 2 and 3 5 mcg, pertactin 3 mcg
Dr. Hsu Li Yang, Dr. Tan Thuan Tong, Dr. Andrea Kwa, 08 Jan 2021
Antimicrobial resistance has become increasingly dire as the rapid emergence of drug resistance, especially gram-negative pathogens, has outpaced the development of new antibiotics. At a recent virtual symposium, Dr Hsu Li Yang, Vice Dean (Global Health) and Programme Leader (Infectious Diseases), NUS Saw Swee Hock School of Public Health, presented epidemiological data on multidrug-resistant (MDR) gram-negative bacteria (GNB) in Asia, while Dr Tan Thuan Tong, Head and Senior Consultant, Department of Infectious Diseases, Singapore General Hospital (SGH), focused on the role of ceftazidime-avibactam in MDR GNB infections. Dr Andrea Kwa, Assistant Director of Research, Department of Pharmacy, SGH, joined the panel in an interactive fireside chat, to discuss challenges, practical considerations, and solutions in MDR gram-negative infections. This Pfizer-sponsored symposium was chaired by Dr Ng Shin Yi, Head and Senior Consultant of Surgical Intensive Care, SGH.
Tristan Manalac, Yesterday
While antibody titres against SARS-CoV-2 wane with time, the immune system is capable of producing memory B-cells that can last for at least 6 months after infection, suggesting that the body will be able to protect itself in the case of re-exposure, according to a new study.
Jairia Dela Cruz, 5 days ago
Spending too much time sitting cannot be good for the body, and rising to one's feet breaks up such a behaviour and yields small, but meaningful, reductions in certain cardiovascular disease (CVD) risk factors, according to the results of a meta-analysis.