Children with congenital heart disease (CHD) frequently become malnourished due to many factors including hypermetabolic state, inadequate caloric intake, malabsorption, and fluid restriction as part of the hemodynamic intervention. The abnormal nutritional status may affect early outcome after pediatric cardiac surgery; we aim to prove the importance of nutritional assessment and patient nutritional preparation before performing pediatric cardiac surgery. We conducted a prospective observational cohort study from March 2013 till January 2015. All children from birth until 14 years of age admitted to the pediatric cardiac intensive care unit (PCICU) after cardiac surgery. Nutritional status was assessed preoperatively and prognostic nutritional index (PNI) was calculated. All post-operative outcome parameters, PCICU and hospital length of stay (LOS), ventilation time, the rate of infection, and ICU mortality were recorded. Two hundred fifty-nine children were evaluated. At admission, 179 patients (69%) had intake less than 50% of the recommended daily allowance (RDA) of calories intake. There was a statistically significant relationship between pre-admission RDA and the infection rate (P value 0.018). Severely malnourished patients had significantly longer ICU length of stay (LOS) (P value = 0.049). Similarly, weight and height percentiles have a significant effect on ICU LOS (P value 0.009 and 0.045) respectively. There was a significant relation between PNI ≥ 55 and the ICU LOS (P < 0.05), and ventilation time (P = 0.036). Delay in feeding postoperatively was associated with a higher risk of infection (P = 0.005), and higher mortality (P = 0.03). Children with CHD were significantly malnourished preoperatively and had further weight loss postoperatively. Preoperative nutritional status and delayed postoperative enteral feeding were associated with a higher infection rate and mortality.

中文翻译：

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先天性心脏病患儿营养状况对术后早期预后的影响

患有先天性心脏病 (CHD) 的儿童经常由于许多因素而营养不良，包括代谢亢进、热量摄入不足、吸收不良和作为血液动力学干预一部分的液体限制。营养状况异常可能会影响小儿心脏手术后的早期结果；我们旨在证明在进行小儿心脏手术之前营养评估和患者营养准备的重要性。我们从 2013 年 3 月到 2015 年 1 月进行了一项前瞻性观察队列研究。所有从出生到 14 岁的儿童在心脏手术后都入住小儿心脏重症监护病房 (PCICU)。术前评估营养状况并计算预后营养指数（PNI）。所有术后结果参数，记录PCIICU和住院时间（LOS）、通气时间、感染率和ICU死亡率。评估了 259 名儿童。入院时，179 名患者 (69%) 的卡路里摄入量低于推荐每日允许摄入量 (RDA) 的 50%。入院前 RDA 与感染率之间存在统计学显着关系（P 值 0.018）。严重营养不良患者的 ICU 住院时间 (LOS) 显着延长（P 值 = 0.049）。同样，体重和身高百分位数分别对 ICU LOS 有显着影响（P 值 0.009 和 0.045）。PNI ≥ 55 与 ICU LOS (P < 0.05) 和通气时间 (P = 0.036) 之间存在显着相关性。术后延迟喂养与较高的感染风险（P = 0.005）和较高的死亡率（P = 0.03）相关。CHD患儿术前明显营养不良，术后体重进一步下降。术前营养状况和术后延迟肠内喂养与较高的感染率和死亡率相关。