Impact of Extubation Time on Feeding Outcomes after Neonatal Cardiac Surgery: A Single-Center Study
Abstract
:1. Introduction
2. Methods
3. Results
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variable | Immediate Extubation n = 32 | Early Extubation n = 43 | Delayed Extubation n = 44 | p-Value |
---|---|---|---|---|
Age, days | 5.0 (3.0–6.5) | 4.0 (3.0–6.0) | 5.5 (4.0–7.0) | 0.117 |
Gestational age | 39.0 (37.6–39.2) | 39.0 (38.0–39.2) | 38.4 (37.3–39.0) | 0.049 |
Weight, kg | 3.3 (2.9–3.6) | 3.3 (3.1–3.8) | 3.2 (2.7–3.6) | 0.121 |
Sex (male) | 16 (50%) | 31 (72%) | 26 (59%) | 0.14 |
Lesion | 0.295 | |||
Aortic arch hypoplasia/coarctation | 9 (27%) | 13 (30%) | 11 (25%) | |
Hypoplastic left heart | 4 (13%) | 2 (5%) | 9 (20%) | |
Interrupted aortic arch | 1 (3%) | 1 (2%) | 3 (7%) | |
Other two ventricles | 3 (9%) | 2 (5%) | 3 (7%) | |
Other single ventricle | 1 (3%) | 2 (5%) | 2 (5%) | |
Pulmonary atresia/IVS 1 | 1 (3%) | 4 (9%) | 2 (5%) | |
Pulmonary atresia/VSD 2 | 2 (6%) | 0 | 3 (7%) | |
TAPVR 3 | 2 (6%) | 4 (9%) | 4 (9%) | |
TGA 4 | 9 (28%) | 13 (30%) | 3 (7%) | |
Truncus arteriosus | 0 | 2 (5%) | 4 (9%) | |
Pre-operative feeds | 0.093 | |||
Oral | 22 (69%) | 23 (53%) | 16 (36%) | |
Nasogastric | 3 (9%) | 5 (12%) | 12 (27%) | |
Oral + nasogastric | 0 | 1 (2%) | 2 (5%) | |
None | 7 (22%) | 14 (33%) | 14 (32%) | |
Post-operative cyanosis | 14 (42%) | 16 (37%) | 31 (70%) | 0.005 |
Surgery | 0.058 | |||
Arch reconstruction | 10 (31%) | 11 (40%) | 16 (36%) | |
Arterial switch | 8 (25%) | 12 (28%) | 2 (5%) | |
BTT shunt | 1 (3%) | 4 (9%) | 0 | |
Norwood + Sano | 4 (13%) | 2 (5%) | 7 (16%) | |
Other two ventricle repair | 6 (19%) | 2 (5%) | 9 (20%) | |
Other single-ventricle palliation | 1 (3%) | 1 (2%) | 2 (5%) | |
TAPVR repair | 1 (3%) | 4 (9%) | 4 (9%) | |
Truncus arteriosus repair | 1 (3%) | 1 (2%) | 4 (9%) | |
STAT 5 category | <0.0001 | |||
1 | 8 (26%) | 1 (2%) | 2 (5%) | |
2 | 1 (3%) | 2 (5%) | 4 (10%) | |
3 | 7 (23%) | 11 (26%) | 5 (12%) | |
4 | 11 (36%) | 27 (63%) | 23 (55%) | |
5 | 4 (13%) | 2 (5%) | 8 (19%) | |
Cardiopulmonary bypass time, minutes | 83 (53–119) | 86 (61–100) | 120 (83–155) | 0.0004 |
Cross clamp time, minutes | 39 (15–48) | 36 (19–52) | 58 (39–77) | 0.0004 |
Variable | Immediate Extubation n = 32 | Early Extubation n = 43 | Delayed Extubation n = 44 | p-Value |
---|---|---|---|---|
Time to extubation, days | 0 | 1.6 (0.9–2.1) | 5.2 (4.2–10.6) | <0.0001 |
Time to first enteral feed, days | 1.3 (1–3.4) | 2.3 (1.1–3.3) | 3.5 (2.2–5.1) | 0.0009 |
Time to first oral feed, days | 2.0 (1.1–4.5) | 3.1 (1.8–4.4) | 8.4 (5.3–15.6) | <0.0001 |
Time to goal feeds, days | 6.0 (3.2–8.3) | 6.9 (5.0–9.0) | 14.5 (10.4–22.3) | <0.0001 |
Length of hospital stay, days | 15.1 (11.6–19.8) | 15.0 (12.3–18.2) | 32.5 (21.2–41.6) | <0.0001 |
z-score change | −0.8 (−1.1–−0.48) | −1.0 (−1.3–−0.47) | −1.2 (−1.5- −0.74) | 0.057 |
Type of first feeds post-op | 0.0001 | |||
Oral | 17 (53%) | 22 (51%) | 5 (11%) | |
Nasogastric bolus | 9 (28%) | 7 (16%) | 13 (30%) | |
Nasogastric continuous | 6 (19%) | 14 (33%) | 26 (59%) | |
Discharge feeds | 0.007 | |||
All oral | 21 (66%) | 30 (70%) | 15 (34%) | |
Oral + tube | 7 (22%) | 9 (21%) | 15 (34%) | |
All tube | 4 (12%) | 4 (9%) | 14 (32%) | |
Feeds at one year | 0.0002 | |||
All oral | 24 (75%) | 41 (95%) | 27 (61%) | |
Oral + tube | 3 (9%) | 1 (2%) | 3 (7%) | |
All tube | 1 (3%) | 0 | 11 (25%) | |
Missing data | 4 (13%) | 2 (5%) | 3 (7%) |
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Kepple, J.W.; Kendall, M.; Ortmann, L.A. Impact of Extubation Time on Feeding Outcomes after Neonatal Cardiac Surgery: A Single-Center Study. Children 2023, 10, 592. https://doi.org/10.3390/children10030592
Kepple JW, Kendall M, Ortmann LA. Impact of Extubation Time on Feeding Outcomes after Neonatal Cardiac Surgery: A Single-Center Study. Children. 2023; 10(3):592. https://doi.org/10.3390/children10030592
Chicago/Turabian StyleKepple, Jeffrey W., Meghan Kendall, and Laura A. Ortmann. 2023. "Impact of Extubation Time on Feeding Outcomes after Neonatal Cardiac Surgery: A Single-Center Study" Children 10, no. 3: 592. https://doi.org/10.3390/children10030592