Efficacy of early enteral feeding with supplemented mother’s milk on postoperative outcomes of cardiac surgical infants: A randomized controlled trial

Introduction: Congenital heart disease (CHD)-associated malnutrition is a systemic consequence of CHD. Dietary recommendations to fulfill nutritional requirements are lacking. This randomized controlled trial (RCT) was conducted to determine the efficacy of early enteral feeding with supplemented ex...

Full description

Saved in:
Bibliographic Details
Main Authors: Anuradha Singal, Manoj Kumar Sahu, Geeta Trilok Kumar, Bani Tamber Aeri, Mala Manral, Anuja Agarwala, Shivam Pandey
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2024-12-01
Series:Annals of Pediatric Cardiology
Subjects:
Online Access:https://journals.lww.com/10.4103/apc.apc_160_24
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1841554784000147456
author Anuradha Singal
Manoj Kumar Sahu
Geeta Trilok Kumar
Bani Tamber Aeri
Mala Manral
Anuja Agarwala
Shivam Pandey
author_facet Anuradha Singal
Manoj Kumar Sahu
Geeta Trilok Kumar
Bani Tamber Aeri
Mala Manral
Anuja Agarwala
Shivam Pandey
author_sort Anuradha Singal
collection DOAJ
description Introduction: Congenital heart disease (CHD)-associated malnutrition is a systemic consequence of CHD. Dietary recommendations to fulfill nutritional requirements are lacking. This randomized controlled trial (RCT) was conducted to determine the efficacy of early enteral feeding with supplemented expressed breast milk (suppl-EBM) versus expressed breast milk (EBM) in improving the weight of postoperative cardiac surgical infants. Objective: The primary objective was the weight change between the EBM group and the suppl-EBM group at the 15th postoperative day (POD) or intensive care unit (ICU) discharge. The secondary objectives were to compare the ventilation duration (VD), length of ICU stay (LOICUS), length of hospital stay (LOHS), macronutrient consumption, adverse events, sepsis, and mortality between the two groups. Materials and Methods: This study was a parallel-group, open-labeled, single-blinded, variable block size RCT conducted at a tertiary care teaching hospital in northern India. Full-term breastfed infants ≤6 months, weighing ≥2.5 kg at birth, and undergoing congenital cardiac repair were enrolled in this study. The infants were fed either EBM or supplemented EBM in control and intervention groups, respectively. Weight and length were measured at baseline and 15th POD or at ICU discharge. Biochemical parameters at baseline and every alternate day, sepsis parameters every third POD and VD, LOICUS, LOHS, macronutrient consumption, and adverse events were assessed daily. Results: The mean weight, weight change percentage, and weight for age z score were significantly higher in the supplemented EBM group (P < 0.05). The macronutrient consumption was significantly higher in the intervention group (P < 0.05). No significant difference was found between the two groups for VD, LOICUS, and LOHS (P > 0.05). The sepsis was higher in the EBM group. However, the mortality rate did not differ between the two groups (P > 0.05). Conclusion: Supplemented feeding may improve the weight of postoperative cardiac infants with no serious adverse events.
format Article
id doaj-art-72a5259f32b34c0e82d77ee00bcf0ece
institution Kabale University
issn 0974-2069
0974-5149
language English
publishDate 2024-12-01
publisher Wolters Kluwer Medknow Publications
record_format Article
series Annals of Pediatric Cardiology
spelling doaj-art-72a5259f32b34c0e82d77ee00bcf0ece2025-01-08T09:25:18ZengWolters Kluwer Medknow PublicationsAnnals of Pediatric Cardiology0974-20690974-51492024-12-0117532033010.4103/apc.apc_160_24Efficacy of early enteral feeding with supplemented mother’s milk on postoperative outcomes of cardiac surgical infants: A randomized controlled trialAnuradha SingalManoj Kumar SahuGeeta Trilok KumarBani Tamber AeriMala ManralAnuja AgarwalaShivam PandeyIntroduction: Congenital heart disease (CHD)-associated malnutrition is a systemic consequence of CHD. Dietary recommendations to fulfill nutritional requirements are lacking. This randomized controlled trial (RCT) was conducted to determine the efficacy of early enteral feeding with supplemented expressed breast milk (suppl-EBM) versus expressed breast milk (EBM) in improving the weight of postoperative cardiac surgical infants. Objective: The primary objective was the weight change between the EBM group and the suppl-EBM group at the 15th postoperative day (POD) or intensive care unit (ICU) discharge. The secondary objectives were to compare the ventilation duration (VD), length of ICU stay (LOICUS), length of hospital stay (LOHS), macronutrient consumption, adverse events, sepsis, and mortality between the two groups. Materials and Methods: This study was a parallel-group, open-labeled, single-blinded, variable block size RCT conducted at a tertiary care teaching hospital in northern India. Full-term breastfed infants ≤6 months, weighing ≥2.5 kg at birth, and undergoing congenital cardiac repair were enrolled in this study. The infants were fed either EBM or supplemented EBM in control and intervention groups, respectively. Weight and length were measured at baseline and 15th POD or at ICU discharge. Biochemical parameters at baseline and every alternate day, sepsis parameters every third POD and VD, LOICUS, LOHS, macronutrient consumption, and adverse events were assessed daily. Results: The mean weight, weight change percentage, and weight for age z score were significantly higher in the supplemented EBM group (P < 0.05). The macronutrient consumption was significantly higher in the intervention group (P < 0.05). No significant difference was found between the two groups for VD, LOICUS, and LOHS (P > 0.05). The sepsis was higher in the EBM group. However, the mortality rate did not differ between the two groups (P > 0.05). Conclusion: Supplemented feeding may improve the weight of postoperative cardiac infants with no serious adverse events.https://journals.lww.com/10.4103/apc.apc_160_24congenital heart diseasepediatric cardiac surgerypostoperative nutritional care
spellingShingle Anuradha Singal
Manoj Kumar Sahu
Geeta Trilok Kumar
Bani Tamber Aeri
Mala Manral
Anuja Agarwala
Shivam Pandey
Efficacy of early enteral feeding with supplemented mother’s milk on postoperative outcomes of cardiac surgical infants: A randomized controlled trial
Annals of Pediatric Cardiology
congenital heart disease
pediatric cardiac surgery
postoperative nutritional care
title Efficacy of early enteral feeding with supplemented mother’s milk on postoperative outcomes of cardiac surgical infants: A randomized controlled trial
title_full Efficacy of early enteral feeding with supplemented mother’s milk on postoperative outcomes of cardiac surgical infants: A randomized controlled trial
title_fullStr Efficacy of early enteral feeding with supplemented mother’s milk on postoperative outcomes of cardiac surgical infants: A randomized controlled trial
title_full_unstemmed Efficacy of early enteral feeding with supplemented mother’s milk on postoperative outcomes of cardiac surgical infants: A randomized controlled trial
title_short Efficacy of early enteral feeding with supplemented mother’s milk on postoperative outcomes of cardiac surgical infants: A randomized controlled trial
title_sort efficacy of early enteral feeding with supplemented mother s milk on postoperative outcomes of cardiac surgical infants a randomized controlled trial
topic congenital heart disease
pediatric cardiac surgery
postoperative nutritional care
url https://journals.lww.com/10.4103/apc.apc_160_24
work_keys_str_mv AT anuradhasingal efficacyofearlyenteralfeedingwithsupplementedmothersmilkonpostoperativeoutcomesofcardiacsurgicalinfantsarandomizedcontrolledtrial
AT manojkumarsahu efficacyofearlyenteralfeedingwithsupplementedmothersmilkonpostoperativeoutcomesofcardiacsurgicalinfantsarandomizedcontrolledtrial
AT geetatrilokkumar efficacyofearlyenteralfeedingwithsupplementedmothersmilkonpostoperativeoutcomesofcardiacsurgicalinfantsarandomizedcontrolledtrial
AT banitamberaeri efficacyofearlyenteralfeedingwithsupplementedmothersmilkonpostoperativeoutcomesofcardiacsurgicalinfantsarandomizedcontrolledtrial
AT malamanral efficacyofearlyenteralfeedingwithsupplementedmothersmilkonpostoperativeoutcomesofcardiacsurgicalinfantsarandomizedcontrolledtrial
AT anujaagarwala efficacyofearlyenteralfeedingwithsupplementedmothersmilkonpostoperativeoutcomesofcardiacsurgicalinfantsarandomizedcontrolledtrial
AT shivampandey efficacyofearlyenteralfeedingwithsupplementedmothersmilkonpostoperativeoutcomesofcardiacsurgicalinfantsarandomizedcontrolledtrial