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Nutrition and Mesenteric Issues in Pediatric Cardiac Critical Care

Floh, Alejandro A. MD, MSc, FRCPC; Slicker, Julie MS, RD, CSP, CD, CNSC; Schwartz, Steven M. MD, MS, FRCPC

doi: 10.1097/PCC.0000000000000801
Organ Systems: Other Organ Systems and Systemic Disorders

Objectives: The objectives of this review are to discuss the challenges of delivering adequate nutrition to children with congenital heart disease, including pre- and postoperative factors and the role of enteral and parenteral nutrition, as well as the evidence supporting current practices.

Data Source: MEDLINE and PubMed.

Conclusion: Providing adequate nutritional support is paramount for critically ill infants with congenital heart disease, a population at particular risk for malnutrition. Improved nutritional support has been associated with increased survival and reduction in overall morbidity. Further gains can be achieved by creating a clinical culture that emphasizes optimal perioperative nutritional support. Additional research is required to identify the specific nutrient composition, optimal mode, and timing of delivery to maximize clinical benefit.

1Department of Pediatrics, Section of Critical Care Medicine, University of Toronto, The Hospital for Sick Children, Toronto, ON, Canada.

2Quality, Outcomes and Research, Herma Heart Center, Children’s Hospital of Wisconsin, Milwaukee, WI.

3Department of Pediatrics, Section of Critical Care Medicine and Cardiology, Section of Cardiac Critical Care Medicine, University of Toronto, The Hospital for Sick Children, Toronto, ON, Canada.

Dr. Floh received funding from the Office of the Chief Coroner–Province of Ontario. Dr. Schwartz received funding from Novartis AG and disclosed other support (the Novartis relationship is unrelated to this work). His institution received funding from the Heart and Stroke Foundation of Canada. Dr. Slicker disclosed that she does not have any potential conflicts of interest.

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©2016The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies