Achieving caloric goal in postoperative management of CHD surgery.

IF 0.7 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Cardiology in the Young Pub Date : 2025-04-01 Epub Date: 2025-02-27 DOI:10.1017/S1047951125000484
Murat Tanyildiz, Selin Ece Erden, Asli Ece Yakici, Omer Ozden, Ipek Otrav, Mehmet Bicer, Atif Akcevin, Ender Odemis
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Abstract

Background: This study investigated the prevalence of malnutrition, time to achieve caloric goals, and nutritional risk factors after surgery for CHD in a cardiac ICU.

Method: This retrospective study included patients with CHD (1 month-18 years old) undergoing open-heart surgery (2021-2022). We recorded nutritional status, body mass index-for-age z-score, weight-for-length/height z-score, cardiopulmonary bypass and aortic cross-clamp time, Paediatric Risk of Mortality-3 score, Paediatric Logistic Organ Dysfunction-2 score, vasoactive inotropic score, total duration of mechanical ventilation, length of stay in the cardiac ICU, mortality, and time to achieve caloric goals.

Results: Of the 75 included patients, malnutrition was detected in 17% (n= 8) based on the body mass index-for-age z-score and in 35% (n= 10) based on the weight-for-length/height z-score. Sex, mortality, cardiopulmonary bypass and aortic cross-clamp time, Paediatric Risk of Mortality-3, Paediatric Logistic Organ Dysfunction-2, and vasoactive inotropic score, duration of mechanical ventilation, and length of cardiac ICU stay were similar between patients with and without malnutrition. Patients who achieved caloric goals on the fourth day and those who achieved them beyond the fourth day showed statistical differences in mortality, maximum vasoactive inotropic score, duration of mechanical ventilation, cardiopulmonary bypass and aortic cross-clamp time, Paediatric Risk of Mortality-3, Paediatric Logistic Organ Dysfunction-2, and length of cardiac ICU and hospital stay (p< 0.05). Logit regression analysis indicated that the duration of mechanical ventilation, Paediatric Logistic Organ Dysfunction-2 and Paediatric Risk of Mortality-3 score was a risk factor for achieving caloric goals (p< 0.05).

Conclusions: Malnutrition is prevalent in patients with CHD, and concomitant organ failure and duration of mechanical ventilation play important roles in achieving postoperative caloric goals.

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冠心病术后管理中热量目标的实现。
背景:本研究调查了心脏病ICU中冠心病手术后的营养不良发生率、达到热量目标的时间和营养危险因素。方法:本回顾性研究纳入接受心脏直视手术(2021-2022)的冠心病患者(1个月-18岁)。我们记录了营养状况、年龄体重指数z-评分、体重/身高z-评分、体外循环和主动脉交叉夹夹时间、儿科死亡风险-3评分、儿科Logistic器官功能障碍-2评分、血管活性肌力评分、机械通气总时间、心脏ICU住院时间、死亡率和达到热量目标的时间。结果:在纳入的75例患者中,17% (n= 8)根据年龄体重指数z-score检测到营养不良,35% (n= 10)根据体重/身高z-score检测到营养不良。性别、死亡率、体外循环和主动脉交叉夹夹时间、儿科死亡风险-3、儿科逻辑器官功能障碍-2、血管活性肌力评分、机械通气持续时间和心脏ICU住院时间在营养不良和非营养不良患者之间相似。第4天达到热量目标的患者与第4天以后达到热量目标的患者在死亡率、最大血管活性肌力评分、机械通气时间、体外循环和主动脉交叉夹夹时间、儿科死亡风险-3、儿科逻辑器官功能障碍-2、心脏ICU和住院时间等方面存在统计学差异(p< 0.05)。Logit回归分析显示,机械通气时间、儿科Logistic脏器功能障碍-2和儿科死亡风险-3评分是实现热量目标的危险因素(p< 0.05)。结论:营养不良在冠心病患者中普遍存在,伴发的器官衰竭和机械通气时间对术后热量目标的实现起重要作用。
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来源期刊
Cardiology in the Young
Cardiology in the Young 医学-小儿科
CiteScore
1.70
自引率
10.00%
发文量
715
审稿时长
4-8 weeks
期刊介绍: Cardiology in the Young is devoted to cardiovascular issues affecting the young, and the older patient suffering the sequels of congenital heart disease, or other cardiac diseases acquired in childhood. The journal serves the interests of all professionals concerned with these topics. By design, the journal is international and multidisciplinary in its approach, and members of the editorial board take an active role in the its mission, helping to make it the essential journal in paediatric cardiology. All aspects of paediatric cardiology are covered within the journal. The content includes original articles, brief reports, editorials, reviews, and papers devoted to continuing professional development.
期刊最新文献
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