Early enteral feeding of neonates with congenital heart disease undergoing congenital heart surgery

Receiving appropriate nutrition support has positive effects both on the growth and the morbidity of patients who had undergone surgery due to congenital heart disease, during their newborn period. The aims of this research are to determine enteral feeding characteristics throughout the postoperative period, to define difficulties and obstacles in oral feeding and to establish dietary guidelines based on the acquired data. From January 2012 to December 2014, 87 patients were retrospectively evaluated. All patients were operated during their newborn period; of whom 85 were diagnosed with transposition of great arteries and 2 were diagnosed with coarctation of aorta. Median age of the cases were 9.37±5.73 days (3-30 days); of whom 60 were male (69%) and 27 were female (31%). Patients' preoperative, operative and postoperative parameters were recorded. During the intensive care unit stay, factors that delayed the transition to full enteral feeding or even interrupt the feeding itself were identified. Enteral feeding was applicable for all patients within the first 24 hours. Full enteral feeding was applicable on average of 3.3 days. Gastric residue was observed on 63.2% of the patients; this was observed among major factors to suspend the feeding. Regarding patients with gastric residue, transition to full enteral feeding was delayed, feeding interruption and feeding suspension frequencies were increased. It was observed that transition periods to enteral feeding took longer, for the patients with feeding interruptions. Neither birth weight, sex or operation age was associated with the feeding. We found out that metabolic factors , residual cardiac defect, renal dysfunction, electrolyte imbalances or glycemic control had no influence on the feeding. We believe that promptly initiation of postoperative enteral feeding contributes; to shorten the hospitalization period, to discharge without any requirement of a feeding support and to reduce the post-discharge homecare feeding difficulties.