Did Malnutrition Affect Post-Operative Somatic Growth in Pediatric Patients Undergoing Surgical Procedures for Congenital Heart Disease?
This study aims to investigate the impact of pre-operative malnutrition on nutritional outcome following congenital heart defects surgery.
This is a prospective cohort study.
Pediatric Cardiac Intensive Care, Harapan Kita National Cardiovascular Center, Jakarta, Indonesia.
Pediatric patients, aged younger than 36 months old with Aristotle score of 6–10, undergoing congenital heart defects surgery with cardiopulmonary bypass were included in this study.
The measured outcome was nutritional outcome based on body weight changes before and after corrective surgery. The measured variables were age, gender, Aristotle score, caloric intake (in pediatric cardiac intensive care unit and pediatric ward), length of stay, albumin level, and prealbumin level.
Among 185 patients, 6% increase of body weight was observed within 12 days of observation (p = 0.007). From bivariate analysis, post-operative nutritional status improvement was significantly associated with pre-operative Z-score for weight-for-age (p = 0.011), caloric intake in pediatric ward (p < 0.0001), and prealbumin level (p = 0.038). From multivariate analysis, caloric intake in pediatric ward remained as a factor which significantly determined post-operative nutritional status (p = 0.001, OR = 1.33, 95% CI 1.014–1.053).
Malnourished patients may have significant improvement in somatic growth following corrective surgery but no effect was observed on the post-operative body weight gain. Adequate nutritional support is important to ensure optimal recovery and better nutritional outcome.
KeywordsCardiopulmonary bypass Cardiac surgery Congenital heart defect Malnutrition Somatic growth
We like to thank our dietitian, Warniati, AMG and our statistician, Nunung Nursyarofah, SKM, MKM.
Compliance with Ethical Standards
Conflict of interest
All authors declared that they had no conflict of interest.
All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Human and Animal Rights
Research involving human participants and/or animals.
Informed consent was obtained from all participants included in the study.
- 3.Radman M, Mack R, Barnoya J, Castañeda A, Rosales M, Azakie A et al (2014) The effect of preoperative nutritional status on postoperative outcomes in children undergoing surgery for congenital heart defects in San Francisco (UCSF) and Guatemala City (UNICAR). J Thor Cardiovasc Surg 147(1):442–450CrossRefGoogle Scholar
- 5.Marwali EM, Kekalih A, Haas NA (2012) The effect of malnutrition on T3 levels in pediatric patients undergoing congenital heart surgery. Crit Care Shock 15:104–110Google Scholar
- 8.Onyango AW, de Onis M (2008) World Health Organization Child Growth Standards: training course on child growth assessment. WHO Press, GenevaGoogle Scholar
- 9.Oey Kam Nio (1992) Dietary food analysis. Balai Penerbit FKUI, JakartaGoogle Scholar
- 18.Bharadwaj S, Ginoya S, Tandon P, Gohel T, Guirguis J, Vallabh H et al (2016) Malnutrition: laboratory markers vs nutritional assessment. Gastroenterol Rep 4:272–280Google Scholar