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Feeding outcomes after paediatric cardiothoracic surgery: a retrospective review

Part of: Surgery

Published online by Cambridge University Press:  07 January 2021

Robert Hill Open the ORCID record for Robert Hill [Opens in a new window] ,
Ching S. Tey ,
Calvin Jung ,
Robert Monfort ,
Brian Pettitt-Schieber ,
William Vaughn ,
Campbell Hathaway ,
Subhadra Shashidharan ,
William Sharp  and
Martha Wetzel
...Show all authors
Robert Hill
Affiliation:
School of Medicine, Mercer University, Macon, GA, USA
Ching S. Tey
Affiliation:
Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
Calvin Jung
Affiliation:
School of Medicine, Mercer University, Macon, GA, USA
Robert Monfort
Affiliation:
School of Medicine, Mercer University, Macon, GA, USA
Brian Pettitt-Schieber
Affiliation:
School of Medicine, Emory University, Atlanta, GA, USA
William Vaughn
Affiliation:
School of Medicine, Mercer University, Macon, GA, USA
Campbell Hathaway
Affiliation:
School of Medicine, University of South Carolina, Greenville, SC, USA
Subhadra Shashidharan
Affiliation:
Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA Children’s Healthcare of Atlanta, Atlanta, GA, USA
William Sharp
Affiliation:
Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA Children’s Healthcare of Atlanta, Atlanta, GA, USA
Martha Wetzel
Affiliation:
Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
Nikhila Raol*
Affiliation:
Children’s Healthcare of Atlanta, Atlanta, GA, USA Department of Otolaryngology, Emory University School of Medicine, Atlanta, GA, USA
*
Author for correspondence: Nikhila Raol MD MPH, Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, 2015 Uppergate Drive, Atlanta, GA 30322, USA. Tel: +1 (404) 785 5437; Fax: +1 (404) 785 9037. E-mail: nikhila.p.raol@emory.edu
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Abstract

Background:

Feeding difficulty is a known complication of congenital heart surgery. Despite this, there is a relative sparsity in the available data regarding risk factors, incidence, associated symptoms, and outcomes.

Methods:

In this retrospective chart review, patients aged 0–18 years who underwent congenital heart surgery at a single institution between January and December, 2017 were reviewed. Patients with feeding difficulties before surgery, multiple surgeries, and potentially abnormal recurrent laryngeal nerve anatomy were excluded. Data collected included patient demographics, feeding outcomes, post-operative symptoms, flexible nasolaryngoscopy findings, and rates of readmission within a 1-year follow-up period. Multivariable regression analyses were performed to evaluate the risk of an alternative feeding plan at discharge and length of stay.

Results:

Three-hundred and twenty-six patients met the inclusion criteria for this study. Seventy-two (22.09%) were discharged with a feeding tube and 70 (97.22%) of this subgroup were younger than 12 months at the time of surgery. Variables that increased the risk of being discharged with a feeding tube included patient age, The Society of Thoracic Surgeons–European Association for Cardio-Thoracic Surgery score, procedure group, aspiration, and reflux. Speech-language pathology was the most frequently utilised consulting service for patients discharged with feeding tubes (90.28%) while other services were not frequently consulted. The median length of stay was increased from 4 to 10 days for patients who required an enteral feeding tube at discharge.

Discussion:

Multidisciplinary management protocol and interventions should be developed and standardised to improve feeding outcomes following congenital heart surgery.

Keywords

PaediatricCHDcongenital heart surgerydysphagiafeeding tube
Type
Original Article
Information
Cardiology in the Young , Volume 31 , Issue 4 , April 2021 , pp. 673 - 681
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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Footnotes

Presentation: Triological Combined Sections Meeting, American Society of Pediatric Otolaryngology, Electronically due to COVID-19 pandemic, May 15, 2020.

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