Acquired feeding difficulties in infants after on-pump cardiac surgery: A single-center retrospective cohort study.

BACKGROUND

Postoperative oral feeding difficulties in infants with congenital heart disease (CHD) are associated with prolonged hospital stays, increased readmission rates, and decreased patients' and their family's quality of life. They have recently been recognized as part of post-intensive care syndrome in pediatrics. The purpose of this study was to identify the risk factors for acquired feeding difficulties after surgery for CHD in infants. We hypothesized that infants who underwent more complex surgical procedures would be at higher risk.

METHODS

We conducted a retrospective observational cohort study in a PICU with 20 beds. Included were 124 eligible patients aged 1-11 months, who had established oral feeding preoperatively and underwent surgery under cardiopulmonary bypass between 2018 and 2022. The primary outcome was the duration from surgery to the re-establishment of oral feeding. We classified the patients into two groups according to the Society of Thoracic Surgeons - European Association for CardioThoracic Surgery (STAT) mortality category.

RESULTS

Eighty-one patients were classified as STAT 1-2 (low) and 43 as STAT 3-5 (high). The duration from surgery to re-establishment of oral feeding was significantly longer in the high-STAT group in one minus Kaplan-Meier curve estimate (p = 0.016). In a multivariable Cox proportional hazards model analysis, longer operative time (HR 0.83, 95% CI 0.72-0.95, p = 0.005) and higher STAT (HR 0.56, 95% CI 0.32-0.95, p = 0.032) were identified as significant risk factors for delayed oral feeding.

CONCLUSIONS

Longer operative times and procedures with higher STAT categories may be associated with acquired feeding difficulties after surgery for CHD in infants.