Document Detail


Weight change in infants with a functionally univentricular heart: from surgical intervention to hospital discharge.
MedLine Citation:
PMID:  21070691     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVE: The purpose of this study was to assess the pattern of weight change from surgical intervention to home discharge and to determine predictors of poor growth in this population of infants with congenital cardiac disease.
METHODS: Neonates with functionally univentricular physiology enrolled in a prospective cohort study examining growth between March, 2003 and May, 2007 were included. Weights were collected at birth, before surgical intervention, and at hospital discharge. In addition, retrospective echocardiographic data and data about post-operative complications were reviewed. Primary outcome variables were weight-for-age z-score at discharge and change in weight-for-age z-score between surgery and discharge.
RESULTS: A total of 61 infants met the inclusion criteria. The mean change in weight-for-age z-score between surgery and hospital discharge was minus 1.5 plus or minus 0.8. Bivariate analysis revealed a significant difference in weight-for-age z-score between infants who were discharged on oral feeds, minus 1.1 plus or minus 0.8 compared to infants with feeding device support minus 1.7 plus or minus 0.7, p-value equal to 0.01. Lower weight-for-age z-score at birth, presence of moderate or greater atrioventricular valve regurgitation, post-operative ventilation time, and placement of an additional central venous line were associated with 60% of the variance in weight-for-age z-score change.ConclusionNeonates undergoing staged surgical repair for univentricular physiology are at significant risk for growth failure between surgery and hospital discharge. Haemodynamically significant atrioventricular valve regurgitation and a complex post-operative course were risk factors for poor post-operative weight gain. Feeding device support appears to be insufficient to ensure adequate weight gain during post-operative hospitalisation.
Authors:
Barbara Medoff-Cooper; Sharon Y Irving; Bradley S Marino; J Felipe García-España; Chitra Ravishankar; Geoffrey L Bird; Virginia A Stallings
Publication Detail:
Type:  Journal Article     Date:  2010-11-12
Journal Detail:
Title:  Cardiology in the young     Volume:  21     ISSN:  1467-1107     ISO Abbreviation:  Cardiol Young     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-02-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9200019     Medline TA:  Cardiol Young     Country:  England    
Other Details:
Languages:  eng     Pagination:  136-44     Citation Subset:  IM    
Affiliation:
1Department of Pediatrics, The Children's Hospital of Philadelphia and School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.
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