Preoperative nutritional status effects postoperative outcome in patients undergoing surgery for congenital heart disease

Objective. - The aim of this study was to evaluate the relationship between preoperative nutritional status and the postoperative clinical outcomes of cardiac surgery performed in children with congenital heart disease (CHD). Methods. - This was a prospective observational study conducted between March 2019-2020, which included 80 patients with CHD. Preoperative nutritional status of the patients was determined by weightfor-age z-score (WAZ), height-for-age z-score (HAZ), serum albumin level, serum prealbumin level. Preoperative myocardial stress was evaluated by serum brain natriuretic peptide (BNP). Vasoactive-Inotropic Score (VIS) measurements were performed pre- and postoperatively. Results. - Malnutrition was present in 15.0% according to HAZ (< -2) and 23.8% according to WAZ (< -2). VIS scores improved significantly after surgical treatment. Albumin decrease was found to be an independent risk factor for the increase in VIS score at 48 hours. There was a negative correlation between prealbumin level and the duration of mechanical ventilation (MV), and also between WAZ and duration of stay in ICU. Increase in cardiopulmonary bypass duration was found to be an independent factor for baseline and 48th hour VIS scores. Duration of aortic cross -clamp was found to positively correlate with duration of MV and VIS scores. BNP levels were positively correlated with MV duration, ICU stay, and 24th and 48th hour VIS scores. A positive correlation was found between RACHS-1 level and the duration of MV and 24th hour VIS score. Conclusion. - Increased nutritional deficiency was found to negatively affect postoperative clinical parameters in children undergoing surgical treatment for CHD. (C) 2021 Societe francophone nutrition clinique et metabolisme (SFNCM). Published by Elsevier Masson SAS. All rights reserved.