Nutrition Support for the Critically Ill Infant Post-Cardiac Surgery

Living reference work entry

Abstract

The incidence of congenital heart disease is approximately 12 per 1,000 newborns in North America. Failure to thrive is prevalent in infants who suffer from congenital heart disease and congestive heart failure. The postoperative clinical course of these infants along with persistent inflammatory catabolic periods contributes to the loss of lean body mass affecting both immune status and hospital outcomes. Prolonged, cumulative caloric and protein deficits occur both before and after staged multiple surgeries with the potential to affect long-term neurological and developmental outcomes. The goal is to match energy expenditure to the energy provided throughout a complex stay. Indirect calorimetry is essential for individualized nutrition prescription as metabolic dysregulation and clinical circumstance vary greatly between children and over the course of each child’s illness. This prescription may involve both enteral and parenteral nutrition and incorporate distinct doses of macro- and micronutrients.

Keywords

Carbohydrate Lactate Selenium Anemia Norepinephrine 

List of Abbreviations

ASD

Atrial septal defect

AVCD

Atrioventricular canal defect

CHD

Congenital heart disease

CHF

Congestive heart failure

CPB

Cardiopulmonary bypass

CRRT

Continuous renal replacement therapy

EN

Enteral nutrition

FTT

Failure to thrive

GIR

Glucose infusion rate

HLHS

Hypoplastic left heart syndrome

IC

Indirect calorimetry

IVLE

Intravenous lipid emulsion

LOS

Length of stay

MREE

Measured resting energy expenditure

NEC

Necrotizing enterocolitis

PD

Peritoneal dialysis

PDA

Patent ductus arteriosus

PICU

Pediatric intensive care unit

REE

Resting energy expenditure

SIRS

Systemic inflammatory response syndrome

TPN

Total parenteral nutrition

VSD

Ventricular septal defect

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.NICU and PICUStollery Children’s HospitalEdmontonCanada
  2. 2.Nutrition Services, Alberta Health ServicesEdmontonCanada

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