OBJECTIVE To determine whether the presence of a standardized feeding protocol improves outcomes in a subset of neonates undergoing cardiac surgery. DESIGN Retrospective cohort study. SETTING Cardiovascular ICU at a freestanding academic children's hospital. PATIENTS Neonates with a diagnosis of d-transposition of the great arteries undergoing arterial switch operation from January 2007 to June 2017. INTERVENTIONS Initiation of perioperative feeding protocols. MEASUREMENTS AND MAIN RESULTS Patients were evaluated before and after implementation of standardized perioperative feeding protocols in neonates with d-transposition of the great arteries undergoing arterial switch operation. Low-risk patients born after initiation of nurse-driven protocols were compared with a similar historical group. Data obtained included time to achievement of feeding goals, with primary outcome being weight gain at hospital discharge. Other measures analyzed included duration of mechanical ventilation and postoperative hospital length of stay. Overall, 33 patients in the protocol group were compared with 44 patients in the historical group. No significant baseline differences existed between the two cohorts. The protocol group achieved improved feeding outcomes in nearly all measured categories, including introduction to enteral feeds preoperatively (91% vs 59%; p < 0.01) and earlier attainment of postoperative full enteral feeds of 120 mL/kg/d (2 vs 5 d; p < 0.01). Protocol patients had significantly improved weight gain at the time of discharge (60 vs 1 g; p < 0.01), while achieving shorter postoperative length of stay (10.1 vs 12.6 d; p = 0.04). CONCLUSIONS An aggressive, but safe, perioperative feeding protocol implemented in a homogenous low-risk neonatal cardiac surgical population improves feeding outcomes, including increased weight gain, as well as decreased postoperative length of stay. Consideration for perioperative feeding protocol implementation and further study should be given.

中文翻译：

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标准化的围手术期喂养方案改善了进行大动脉切换手术的大动脉经d移位的患者的结局。

目的确定标准化喂养方案是否能改善部分接受心脏手术的新生儿的结局。设计回顾性队列研究。在独立的学术儿童医院设置心血管ICU。患者2007年1月至2017年6月诊断为经历大动脉转换手术的大动脉d移位。干预措施开始围手术期喂养方案。测量和主要结果在标准化围手术期喂养方案实施前后的新生儿中，对经历大动脉切换手术的大动脉进行d转位，对患者进行评估。护士驱动方案启动后出生的低危患者与相似的历史人群进行了比较。获得的数据包括达到喂养目标的时间，主要结果是出院时体重增加。分析的其他措施包括机械通气时间和术后住院时间。总体上，方案组中的33例患者与历史组中的44例患者进行了比较。两个队列之间没有明显的基线差异。协议组在几乎所有测量类别中均改善了喂养效果，包括术前采用肠内喂养（91％vs 59％； p <0.01）以及术后早期获得120 mL / kg / d的全肠内喂养（2 vs 5 d） ； p <0.01）。方案患者出院时体重增加显着改善（60 vs 1 g； p <0.01），而术后住院时间更短（10.1 vs 12.6 d； p = 0.04）。结论在同质的低危新生儿心脏外科手术人群中实施了一种积极但安全的围手术期喂养方案，可以改善喂养效果，包括增加体重，并缩短术后住院时间。应考虑围手术期喂养方案的实施和进一步研究。