Article

Rapid advancement to more concentrated formula in infants after surgery for congenital heart disease reduces duration of hospital stay: a randomized clinical trial.

Divisions of Cardiology and Gastroenterology, Department of Pediatrics, University of Toronto, The Hospital for Sick Children, Toronto, Ontario, Canada.
Journal of Pediatrics (impact factor: 4.11). 01/2005; 145(6):761-6. DOI:10.1016/j.jpeds.2004.07.043
Source: PubMed

ABSTRACT To determine the impact of rapid advancement to more concentrated formula on weight gain and duration of hospitalization for infants after cardiac surgery.
We performed a double-blinded, randomized trial of rapid advancement to higher achieved formula concentration for postoperative infants younger than 1 year of age. After transfer to the inpatient ward from the critical care unit, infants were randomly assigned to rapid advancement to a higher achieved formula concentration (2-day transition) or usual care (5-day transition, lower concentration target).
The adequacy of energy intake (expressed as the median percentage of the estimated energy requirement) before discharge from the hospital was 98% in the intervention versus 78% in the usual care group ( P = .01). Before discharge, the median rate of weight gain was greater in the rapid advancement (20 g/d) versus the usual care group (loss of 35 g/d, P < .03). The median postoperative duration of stay on the cardiology inpatient unit was 5 days for the intervention versus 6 days for the usual care group ( P < .05).
Rapid advancement to higher achieved formula concentration significantly improved energy intake and weight gain and decreased duration of postoperative hospital stay in infants after cardiac surgery.

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Keywords

2-day transition
 
cardiac surgery
 
cardiology inpatient unit
 
concentrated formula
 
critical care unit
 
double-blinded
 
energy intake
 
estimated energy requirement
 
formula concentration
 
hospitalization
 
inpatient
 
lower concentration target
 
median percentage
 
median postoperative duration
 
postoperative infants younger
 
randomized trial
 
rapid advancement
 
usual care
 
usual care group
 
weight gain
 

Francy Pillo-Blocka