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The association between feeding protocol compliance and weight gain following high-risk neonatal cardiac surgery

Published online by Cambridge University Press:  24 May 2019

Jamie M. Furlong-Dillard Open the ORCID record for Jamie M. Furlong-Dillard [Opens in a new window] ,
Benjamin J. Miller ,
Kathy A. Sward ,
Alaina I. Neary ,
Trudy L. Hardin-Reynolds ,
Grace Jeffers ,
Bonnie A. Clay ,
Dongngan T. Truong ,
Thomas A. Miller  and
Courtney E. Jones
...Show all authors
Jamie M. Furlong-Dillard*
Affiliation:
Division of Critical Care, Department of Pediatrics, University of Louisville, Norton Children’s Hospital, Louisville, KY, USA
Benjamin J. Miller
Affiliation:
Division of Critical Care, Department of Pediatrics, University of Utah, Primary Children’s Hospital, Salt Lake City, UT, USA
Kathy A. Sward
Affiliation:
Division of Critical Care, Department of Pediatrics, University of Utah, Primary Children’s Hospital, Salt Lake City, UT, USA
Alaina I. Neary
Affiliation:
Division of Speech Language Pathology, Department of Pediatrics, Primary Children’s Hospital, Intermountain Healthcare, Salt Lake City, UT, USA
Trudy L. Hardin-Reynolds
Affiliation:
Division of Pediatric Critical Care, Department of Pediatrics, Primary Children’s Hospital, Intermountain Healthcare, Salt Lake City, UT, USA
Grace Jeffers
Affiliation:
Division of Pediatric Critical Care, Department of Pediatrics, Primary Children’s Hospital, Intermountain Healthcare, Salt Lake City, UT, USA
Bonnie A. Clay
Affiliation:
Division of Cardiothoracic Surgery, Department of Surgery, Primary Children’s Hospital, Intermountain Healthcare, Salt Lake City, UT, USA
Dongngan T. Truong
Affiliation:
Division of Pediatric Cardiology, Department of Pediatrics, University of Utah, Salt Lake City, UT, USA
Thomas A. Miller
Affiliation:
Division of Pediatric Cardiology, Department of Pediatrics, University of Utah, Salt Lake City, UT, USA
Courtney E. Jones
Affiliation:
Division of Speech Language Pathology, Department of Pediatrics, Primary Children’s Hospital, Intermountain Healthcare, Salt Lake City, UT, USA
Linda M. Lambert
Affiliation:
Division of Cardiothoracic Surgery, Department of Surgery, Primary Children’s Hospital, Intermountain Healthcare, Salt Lake City, UT, USA
David K. Bailly
Affiliation:
Division of Critical Care, Department of Pediatrics, University of Utah, Primary Children’s Hospital, Salt Lake City, UT, USA
*
Author for correspondence: Jamie M. Furlong-Dillard, Division of Critical Care, Department of Pediatrics, University of Louisville, Norton Children’s Hospital, DO 571 S Floyd St, Suite 332 Louisville, KY 40202, USA. Tel: 678-294-0735; Fax: 502-852-3998; E-mail: [email protected]
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Abstract

Background:

Children with congenital heart disease are at high risk for malnutrition. Standardisation of feeding protocols has shown promise in decreasing some of this risk. With little standardisation between institutions’ feeding protocols and no understanding of protocol adherence, it is important to analyse the efficacy of individual aspects of the protocols.

Methods:

Adherence to and deviation from a feeding protocol in high-risk congenital heart disease patients between December 2015 and March 2017 were analysed. Associations between adherence to and deviation from the protocol and clinical outcomes were also assessed. The primary outcome was change in weight-for-age z score between time intervals.

Results:

Increased adherence to and decreased deviation from individual instructions of a feeding protocol improves patients change in weight-for-age z score between birth and hospital discharge (p = 0.031). Secondary outcomes such as markers of clinical severity and nutritional delivery were not statistically different between groups with high or low adherence or deviation rates.

Conclusions:

High-risk feeding protocol adherence and fewer deviations are associated with weight gain independent of their influence on nutritional delivery and caloric intake. Future studies assessing the efficacy of feeding protocols should include the measures of adherence and deviations that are not merely limited to caloric delivery and illness severity.

Keywords

Feedingprotocolcongenital heart diseaseweight-for-age z score
Type
Original Article
Information
Cardiology in the Young , Volume 29 , Issue 5 , May 2019 , pp. 594 - 601
Copyright
© Cambridge University Press 2019 

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