caa a22 4500 445825065 CHVBK 20180317145256.0 cr unu---uuuuu 170323e20110401xx s 000 0 eng 10.1007/s00246-010-9864-9 doi (NATIONALLICENCE)springer-10.1007/s00246-010-9864-9 Comparison of Gastrointestinal Morbidity After Norwood and Hybrid Palliation for Complex Heart Defects [Elektronische Daten] [Scott Weiss, Jeffrey Gossett, Sunjay Kaushal, Deli Wang, Carl Backer, Eric Wald] This study aimed to compare the incidence of gastrointestinal complications among infants with single-ventricle heart defects after three first-stage palliation strategies: Norwood-modified Blalock-Taussig shunt (mBTS), Norwood right ventricle-to-pulmonary artery conduit (Sano), and hybrid procedures. A retrospective chart review was performed in a pediatric cardiac intensive care unit at a tertiary care medical center. The subjects were 32 neonates who had undergone single-ventricle palliation including 13 Norwood-mBTS, 11 Sano, and 8 hybrid procedures. The measurements included baseline as well as pre- and postoperative patient characteristics. The primary outcome was postoperative intraabdominal complications, and the secondary outcomes were feeding intolerance and necrotizing enterocolitis (NEC). Intraabdominal complications occurred for 34%, feeding intolerance for 13%, and NEC for 13% of the patients. The hybrid patients had a higher incidence of intraabdominal complications (75%) than the Norwood-mBTS (31%) or Sano (9%) patients (P=0.01). The relative risk for intraabdominal complications in the hybrid group was 3.6 (95% confidence interval [CI], 1.5-8.7). In the multivariate analysis, the hybrid procedure remained an independent predictor of intraabdominal complications (hazard ratio, 8.4; 95% CI, 2.0-34.5). The hybrid, Norwood-mBTS, and Sano patients did not differ significantly in terms of feeding intolerance (25, 15, and 0%, respectively; P=0.25) or NEC (25, 8, and 9%; P=0.46). Gastrointestinal morbidity was common regardless of the palliative approach, although the hybrid patients had the highest incidence of intraabdominal complications. This supports the need for caution in using enteral nutrition with all single-ventricle patients, including the hybrid population. Patients undergoing the hybrid procedure may benefit from implementation of standardized feeding protocols. Springer Science+Business Media, LLC, 2010 Cardiac surgery nationallicence Congenital nationallicence Enterocolitis nationallicence Heart defects nationallicence Intensive care nationallicence Weiss Scott Division of Critical Care, Department of Pediatrics, Children's Memorial Hospital, Northwestern University Feinberg School of Medicine, 2300 Children's Plaza, 60614-3394, Chicago, IL, USA aut Gossett Jeffrey Division of Cardiology, Department of Pediatrics, Children's Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL, USA aut Kaushal Sunjay Division of Cardiovascular-Thoracic Surgery, Department of Surgery, Children's Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL, USA aut Wang Deli Biostatistics Research Core, Children's Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL, USA aut Backer Carl Division of Cardiovascular-Thoracic Surgery, Department of Surgery, Children's Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL, USA aut Wald Eric Division of Critical Care, Department of Pediatrics, Children's Memorial Hospital, Northwestern University Feinberg School of Medicine, 2300 Children's Plaza, 60614-3394, Chicago, IL, USA aut Pediatric Cardiology Springer-Verlag 32/4(2011-04-01), 391-398 0172-0643 32:4<391 2011 32 246 https://doi.org/10.1007/s00246-010-9864-9 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00246-010-9864-9 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Weiss Scott Division of Critical Care, Department of Pediatrics, Children's Memorial Hospital, Northwestern University Feinberg School of Medicine, 2300 Children's Plaza, 60614-3394, Chicago, IL, USA aut NATIONALLICENCE 700 1- Gossett Jeffrey Division of Cardiology, Department of Pediatrics, Children's Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL, USA aut NATIONALLICENCE 700 1- Kaushal Sunjay Division of Cardiovascular-Thoracic Surgery, Department of Surgery, Children's Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL, USA aut NATIONALLICENCE 700 1- Wang Deli Biostatistics Research Core, Children's Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL, USA aut NATIONALLICENCE 700 1- Backer Carl Division of Cardiovascular-Thoracic Surgery, Department of Surgery, Children's Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL, USA aut NATIONALLICENCE 700 1- Wald Eric Division of Critical Care, Department of Pediatrics, Children's Memorial Hospital, Northwestern University Feinberg School of Medicine, 2300 Children's Plaza, 60614-3394, Chicago, IL, USA aut NATIONALLICENCE 773 0- Pediatric Cardiology Springer-Verlag 32/4(2011-04-01), 391-398 0172-0643 32:4<391 2011 32 246 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer