Early Enteral Nutrition in Pediatric Postoperative Cardiac Patients: Optimizing Recovery and Outcomes

Abstract

Background: Congenital heart disease (CHD) affects 8/1000 live births and often causes early feeding difficulties and growth failure, especially in cases with cyanosis or heart failure.

Aim: To assess the impact of early enteral nutrition on postoperative outcomes in pediatric cardiac patients and promoted a team-based approach to nutritional care.

Patients and methods: This prospective two-phase study was conducted at Cairo University's Pediatric Cardiac Intensive Care Unit, involving 117 pediatric patients with CHD who underwent cardiac surgery. Phase 1 involved 57 patients, while Phase 2 involved 60 patients, including 34 males.

Results: Implementation of a structured feeding protocol in the postoperative ICU improved nutritional delivery and clinical outcomes. Enteral feeding was initiated earlier, with median NPO days reduced from 4 to 1, and full caloric intake achieved faster (6.5 vs. 4 days). Feeding success increased from 87.7% to 100%, and full intake from 73.7% to 98.3%. ICU survival improved significantly (70.2% to 91.7%, p = 0.004), with reduced ventilation duration (48 vs. 24 h, p = 0.007) and ICU stay (9 vs. 7 days, p = 0.017). Inflammatory markers (TLC and CRP) declined significantly postoperatively. Subgroup analysis showed early enteral feeding (<48 h) was associated with shorter ventilation (24 vs. 48 h), shorter ICU stay (5 vs. 15 days), and lower mortality (0% vs. 5%), all with significant p-values.

Conclusion: Early nutrition is crucial for children's heart surgery recovery.