Abstract 15498: Monitoring of Nutrition Status by a Registered Dietitian Improves Growth in Single Ventricle Patients
Background: Growth failure and malnutrition is common in infants with hypoplastic left heart syndrome (HLHS) between stage one (S1) and stage two (S2) palliation. It has been shown that nutrition status during this period has a measurable effect on morbidity and mortality outcomes.
Objective: Determine if increased monitoring and nutrition intervention by medical staff including a registered dietitian improves nutrition status and growth during the interstage period.
Methods: Data was collected on 23 infants before and after a home monitoring program was initiated (11 pre-dietitian monitoring, 12 post-dietitian monitoring). Prior to the program, outpatient nutrition was managed by the pediatrician or cardiologist independently. Patients in the program were discharged from the hospital with an infant scale and daily record of weight and formula intake by a family member. This information was reviewed by the clinical team, including a registered dietitian. Nutrition intervention was initiated when formula intake and/or weight gain was suboptimal. Weight and length measurements were obtained at S1 discharge and on admission for S2 surgery. Suboptimal average daily weight gain (<20 gm/day average) and occurrence of growth failure (decreasing > 2 growth curve percentiles on the 2000 CDC growth charts) was compared between groups.
Results: In the pre- dietitian monitoring group, 45% of infants experienced both growth failure and suboptimal weight gain, compared to 25% of infants with suboptimal weight gain and 8% with growth failure in the post- dietitian monitoring group.
Conclusion: Increased monitoring by a registered dietitian increased average weight gain and decreased the occurrence of growth failure during S1 and S2 of palliation. Incorporating a registered dietitian into the clinical team can provide vital expertise to achieve adequate weight gain and growth for HLHS infants during the inter-stage period.
- © 2011 by American Heart Association, Inc.