The effect of different energy feeding on nutrition and clinical prognosis of children with congenital heart disease

Objective To evaluate the effects of different energy feeding on the nutritional status, clinical course and outcome of children with congenital heart disease (CHD) in PICU. Methods Forty cases of hospitalized CHD children were selected as research objects from July 1, 2016 to February 28, 2017.They were randomly divided into two groups, one group(high-calorie milk group, n=20) were fed with high-calorie milk and the other(common milk group, n=20)were fed with common milk.The nutritional status of the two groups were calculated by physical measurements, laboratory indicators, nutrition risk screening and resting energy expenditure.This research also calculated the liquid and energy per day, compared their actual feeding situation, assessed their nutritional status and cardiac function at discharge, and compared the hospital stay, preoperative and postoperative mechanical ventilation time and postoperative fever time. Results There was no statistical difference in the assessment of malnutrition during the discharge of high-calorie milk group.In common milk group, the proportion of moderate to severe malnutrition of discharge was significantly higher than that of admission(χ2=2.537, P=0.042). The proportion of moderate to severe malnutrition was great higher in common milk group than that in high-calorie milk group, but there was no statistical difference, and neither in nutritional risk screening nor cardiac function between the two groups at discharge.Albumin and transferrin of high-calorie milk group were significantly higher than those of the common milk group(t=2.195, P=0.034; t=2.064, P=0.046). Also the number of appropriate energy supply and feeding cases in the high-calorie group were higher than those in the common milk group(t=2.334, P=0.025; χ2 =10.600, P=0.005). Nine cases underwent cardiopulmonary operation in the two groups respectively.There was no statistical difference in the time of ventilatory support between the two groups before and after operation, but the fever time of high-calorie milk group was significantly lower than that of the common milk group(t=2.439, P=0.027). Conclusion The incidence of malnutrition and undernourishment of children with CHD is high, and the incidence of nutrition risk is high, therefore increasing energy supply of children with CHD without increasing the heart load could improve their nutrition status and clinical outcome. Key words: Congenital heart disease; Malnutrition; Clinical prognosis; Calorie; Feeding,