RT Journal Article
SR Electronic
T1 Low risk of necrotising enterocolitis in enterally fed neonates with critical heart disease: an observational study
JF Archives of Disease in Childhood - Fetal and Neonatal Edition
JO Arch Dis Child Fetal Neonatal Ed
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP 609
OP 614
DO 10.1136/archdischild-2019-318537
VO 105
IS 6
A1 Kajsa Nordenström
A1 Katarina Lannering
A1 Mats Mellander
A1 Anders Elfvin
YR 2020
UL http://fn.bmj.com/content/105/6/609.abstract
AB Objective We aimed to investigate the frequency of necrotising enterocolitis (NEC) in infants with critical congenital heart disease (CCHD) hypothesising that preoperative enteral feeding does not increase the risk of NEC.Background When NEC affects term infants, underlying risk factors such as asphyxia, sepsis or CCHD are often found. Due to fear of NEC development in infants with CCHD great caution is practised in many countries to defer preoperative enteral feeding, but in Sweden this is routinely provided.Design, setting and patients An observational study of all infants born with CCHD who were admitted to Queen Silvia Children’s Hospital in Gothenburg between 2010 and 2017. The International Classification of Diseases 10th Revision diagnosis code of NEC was used to identify NEC cases in this group. Infants described as ‘fully fed’ or who were fed at least 45 mL/kg/day before cardiac surgery were identified.Main outcome measures NEC in infants with CCHD in relation to preoperative enteral feeding.Results There were 458 infants with CCHD admitted during the study period. 408/458 were born at term and 361/458 required prostaglandin E1 before surgery. In total, 444/458 infants (97%) were fully fed or fed at least 45 mL/kg daily before cardiac surgery. Four of 458 infants developed NEC (0.9%). All four had other risk factors for NEC.Conclusions This study showed a low risk of NEC in term infants fed enterally before cardiac surgery. We speculate that preoperative enteral feeding of neonates with CCHD does not increase the risk of NEC development.