Document Detail

Normal interstage growth after the norwood operation associated with interstage home monitoring.
MedLine Citation:
PMID:  22526219     Owner:  NLM     Status:  MEDLINE    
After stage 1 palliation (S1P) with a Norwood operation, infants commonly experience growth failure during the initial interstage period. Growth failure during this high-risk period is associated with worse outcomes. This study evaluated the growth patterns of patients enrolled in the authors' interstage home-monitoring program (HMP), which uses a multidisciplinary team approach to nutrition management. From 2000 to 2009, 148 infants were enrolled in the HMP after S1P. Families recorded daily weights during the interstage period and alerted the interstage monitoring team about protocol violations of nutritional goals. Interstage monitoring and inpatient data from the S1P hospitalization were reviewed to identify risk factors for poor growth. Growth outcomes were compared with published norms from the Centers for Disease Control. Interstage survival for patients in the HMP was 98 % (145/148). Growth velocity during the interstage period was 26 ± 8 g/day. The weight-for-age z-scores decreased from birth to discharge after S1P (-0.4 ± 0.9 to -1.3 ± 0.9; p < 0.001) but then increased during the interstage period to the time of S2P (-0.9 ± 1; p < 0.001). The factors associated with improved growth during the interstage period included male gender, greater birth weight, full oral feeding at S1P discharge, and a later birth era. After S1P, infants enrolled in an HMP experienced normal growth velocity during the interstage period. Daily observation of oxygen saturation, weight change, and enteral intake together with implementation of a multidisciplinary feeding protocol is associated with excellent interstage growth and survival.
David A Hehir; Nancy Rudd; Julie Slicker; Kathleen A Mussatto; Pippa Simpson; Shun-Hwa Li; Michele A Frommelt; James S Tweddell; Nancy S Ghanayem
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Publication Detail:
Type:  Journal Article     Date:  2012-04-20
Journal Detail:
Title:  Pediatric cardiology     Volume:  33     ISSN:  1432-1971     ISO Abbreviation:  Pediatr Cardiol     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-28     Completed Date:  2013-05-27     Revised Date:  2013-07-12    
Medline Journal Info:
Nlm Unique ID:  8003849     Medline TA:  Pediatr Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1315-22     Citation Subset:  IM    
Division of Pediatric Critical Care, Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, WI, 53201, USA.
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MeSH Terms
Body Weight
Continuity of Patient Care
Extracorporeal Membrane Oxygenation
Failure to Thrive / etiology*,  prevention & control*
Heart Defects, Congenital / surgery*
Home Care Services, Hospital-Based*
Infant, Newborn
Linear Models
Monitoring, Physiologic / methods*
Norwood Procedures*
Nutritional Support*
Reoperation / statistics & numerical data
Risk Factors
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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