Abstract 16939: Tube-assisted Feeding is Associated With Worse Longitudinal Growth in Children With Single Ventricle Cardiac Disease
Introduction: Children with single ventricle cardiac disease (SVCD) have poor growth in early life. Tube-assisted feeding (TF) has increasingly been used to improve weight gain in SVCD patients, but little is known about its long-term effects on growth. We sought to compare the longitudinal growth of SVCD patients receiving TF at the time of hospital discharge after initial cardiac surgery with those fed entirely by mouth.
Methods: We conducted a retrospective cohort study of patients who underwent initial surgical palliation for SVCD from 1999 to 2009, excluding premature infants (<37 weeks) and patients with non-cardiac chronic conditions, including known genetic syndromes. TF was defined as nasogastric, gastrostomy, or jejunostomy tube feeds for primary or supplementary nutrition. We used non-parametric analysis to compare median weight, height, and BMI for age z-scores at each year of life between those receiving TF and those fed exclusively by mouth upon hospital discharge. A secondary analysis examined the effect of anatomy on growth between those with hypoplastic left heart syndrome (HLHS) compared to other SVCD. Mixed effects linear regression was used to assess rate of growth in the two groups.
Results: A total of 135 patients met inclusion criteria; 64% were male and 50% had HLHS. There were 44 patients (33%) in the TF group. Median weight z-score was significantly lower in the TF group at each year of life from ages 2 to 6 years (p<0.05) compared to those fed by mouth (Figure 1A). Similar findings were seen for height and BMI z-scores (Figures 1B and 1C). Growth z-scores were not associated with anatomic subtype. There was no significant difference in the rate of change in growth parameter z-scores between the two groups.
Conclusions: Long-term growth of children with SVCD who require TF at hospital discharge is diminished compared to that of peers who are fed entirely by mouth. TF patients with SVCD do not experience catch-up growth during early childhood.
Author Disclosures: A. Butto: None. L. Mercer-Rosa: None. C. Daymont: None. J. Edelson: None. E. Mejia: None. M.S. Cohen: None.
- © 2016 by American Heart Association, Inc.