@Article{chd.12742,
AUTHOR = {Jeannine M. Hoch, Oluwatosin Fatusin, Gayane Yenokyan, W. Reid Thompson, Maureen A. Lefton‐Greif},
TITLE = {Feeding methods for infants with single ventricle physiology are associated with length of stay during stage 2 surgery hospitalization},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {14},
YEAR = {2019},
NUMBER = {3},
PAGES = {438--445},
URL = {http://www.techscience.com/schd/v14n3/38788},
ISSN = {3071-1738},
ABSTRACT = {<b>Background:</b> Tube feedings are often needed to achieve the growth and nutrition goals 
associated with decreased morbidity and mortality in patients with single ventricle anat‐
omy. Variability in feeding method through the interstage period has been previously 
described, however, comparable information following stage 2 palliation is lacking.<br/>
<b>Objectives:</b> To identify types of feeding methods following stage 2 palliation and 
their influence on length of stay.<br/>
<b>Design:</b> Secondary analysis of the National Pediatric Cardiology Quality Improvement 
Collaborative registry was performed on 932 patients. Demographic data, medical 
characteristics, postoperative complications, type of feeding method, and length of 
stay for stage 2 palliation were analyzed.<br/>
<b>Results:</b> Type of feeding method remained relatively unchanged during hospitalization 
for stage 2 palliation. Gastrostomy tube fed only patients were the oldest at time of 
surgery (182.7 ± 57.7 days, P < .001) and had the lowest weight‐for‐age z scores at ad‐
mission (−1.6 ± 1.4, P < .001). Oral + gastrostomy tube groups had the longest median 
bypass times (172.5 minutes, P = .001) and longest length of stay (median 12 days, 
P < .001). Multivariable modeling revealed that feeding by tube only (P < .001), oral + 
tube feeding (P ≤ .001), reintubation (P < .001), and prolonged intubation (P < .001) 
were associated with increased length of stay. Neither age (P = .156) nor weight‐for‐age 
z score at admission (P = .066) was predictive of length of stay.<br/>
<b>Conclusions:</b> Feeding methods established at admission for stage 2 palliation are not 
likely to change by discharge. Length of stay is more likely to be impacted by tube 
feeding and intubation history than age or weight‐for‐age z score at admission. Better 
understanding for selection of feeding methods and their impact on patient out‐
comes is needed to develop evidence‐based guidelines to decrease variability in clini‐
cal practice patterns and provide appropriate counseling to caregivers.},
DOI = {10.1111/chd.12742}
}