Clinical Effect of an Improved Post-Operative Feeding Protocol "in Transition" Infants of Congenital Heart Disease with Pulmonary Hypertension

Background: To achieve successful management of infants with congenital heart disease (CHD) together with pulmonary hypertension (PH), postoperative care, especially feeding care is vital in addition to surgery. Postoperative feeding is comprised of three stages: feeding in the intensive care unit, feeding in the general ward and family feeding, in which the general ward is considered as the "transitional stage". At present, there is little research on the optimal mode of feeding care for the transitional stage, and there is no universally recognized and accepted protocol. Methods: We retrospectively analyzed 114 CHD infants with PH who underwent family-centered (FC) feeding care from July 2017 to December 2018, and prospectively studied 122 CHD infants with the same baseline level who adopted the improved mode, nurse-parent-driven (NPD) feeding mode from January 2019 to June 2020. The feasibility and efficacy of NPD as a "transitional" feeding nursing mode in CHD infants with PH were compared with the FC cohort by observing and analyzing the stress of family caregivers, feedingrelated complications, the proportion of breastfeeding, improvement of nutritional status, acquisition of knowledge and skills of feeding care, inpatient's satisfaction rating and prognosis. Results: When compared with the FC feeding care, the NPD mode significantly reduced the burden of family caregivers, improved the rate of feeding care knowledge and skills and inpatient's satisfaction rating, reduced the incidence of improper feeding-related complications, and enhanced the proportion of breastfeeding and nutritional status of infants at the "transitional stage" (all P < 0.05). The self-assessment score of care ability of family caregivers and weight gain of children in the NPD group were significantly higher than those in the FC group (all P < 0.05) during the follow-up. Conclusions: As a transitional mode of feeding in CHD infants with PH, NPD feeding care is superior to the conventional FC mode, which therefore can be adopted as a standard protocol in clinical practice.