caa a22 4500 445825103 CHVBK 20180317145256.0 cr unu---uuuuu 170323e20110401xx s 000 0 eng 10.1007/s00246-011-9907-x doi (NATIONALLICENCE)springer-10.1007/s00246-011-9907-x Feeding Complications in Hypoplastic Left Heart Syndrome After the Norwood Procedure: A Systematic Review of the Literature [Elektronische Daten] [Jessica Golbus, Brandon Wojcik, John Charpie, Jennifer Hirsch] Gastrointestinal and feeding complications after the Norwood procedure in infants with hypoplastic left heart syndrome increases morbidity and mortality. These problems are the result of intraoperative challenges, shunt-dependent physiology, and the absence of best-practice guidelines. In response, a systematic review of feeding-related complications and management strategies was performed. A literature search from 1950 to March 2010 identified 21 primary research articles and 4 reviews. Dysphagia, necrotizing enterocolitis (NEC), and poor nutritional status are significant feeding-related complications. Three studies directly compared the modified Blalock-Taussig shunt with the right ventricle-to-pulmonary artery conduit (RV-PA). Patients palliated with either shunt had impaired mesenteric blood flow. Mortality did not differ between shunt types. Three studies demonstrated improved outcomes, e.g., increased survival, decreased incidence of NEC, and decreased median time to recommended daily allowance of calories, with a postoperative feeding algorithm. Two studies showed increased survival between stage I and II surgical palliation after implementation of a home-monitoring system consisting of daily weight and systemic oxygen saturation measurements. The RV-PA shunt does not significantly alter mortality or increase mesenteric blood flow. A postoperative feeding algorithm and a home-monitoring system may improve outcomes and decrease average hospital length of stay (LOS). Additional studies are needed to determine which interventions, as part of a standardized protocol, improve survival and decrease complications. Springer Science+Business Media, LLC, 2011 Hypoplastic left heart syndrome nationallicence Feeding complications nationallicence Necrotizing enterocolitis nationallicence Norwood procedure nationallicence Congenital heart defect nationallicence Algorithm nationallicence Golbus Jessica University of Michigan Medical School, 1301 Catherine Road, 48109-5864, Ann Arbor, MI, USA aut Wojcik Brandon University of Michigan Medical School, 1301 Catherine Road, 48109-5864, Ann Arbor, MI, USA aut Charpie John Department of Pediatrics, L1242 Womens, SPC 5204, C.S. Mott Children's Hospital, 1500 E. Medical Center Drive, 48109-5864, Ann Arbor, MI, USA aut Hirsch Jennifer Section of Cardiac Surgery, Department of Surgery, University of Michigan Medical School, 5144 Cardiovascular Center, SPC 5864 1500 E. Medical Center Drive, 48109-5864, Ann Arbor, MI, USA aut Pediatric Cardiology Springer-Verlag 32/4(2011-04-01), 539-552 0172-0643 32:4<539 2011 32 246 https://doi.org/10.1007/s00246-011-9907-x text/html Onlinezugriff via DOI 1 review-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00246-011-9907-x text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Golbus Jessica University of Michigan Medical School, 1301 Catherine Road, 48109-5864, Ann Arbor, MI, USA aut NATIONALLICENCE 700 1- Wojcik Brandon University of Michigan Medical School, 1301 Catherine Road, 48109-5864, Ann Arbor, MI, USA aut NATIONALLICENCE 700 1- Charpie John Department of Pediatrics, L1242 Womens, SPC 5204, C.S. Mott Children's Hospital, 1500 E. Medical Center Drive, 48109-5864, Ann Arbor, MI, USA aut NATIONALLICENCE 700 1- Hirsch Jennifer Section of Cardiac Surgery, Department of Surgery, University of Michigan Medical School, 5144 Cardiovascular Center, SPC 5864 1500 E. Medical Center Drive, 48109-5864, Ann Arbor, MI, USA aut NATIONALLICENCE 773 0- Pediatric Cardiology Springer-Verlag 32/4(2011-04-01), 539-552 0172-0643 32:4<539 2011 32 246 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer