Hypoplastic Left Heart Syndrome Clinical Trial
Official title:
Comparison of Feeding Strategies After Stage 1 Procedures for Hypoplastic Left Heart Syndrome Infants: A Randomized Controlled Trial
The purpose of the study is to determine if a continuous feeding regimen as compared to an intermittent bolus feeding regimen leads to improved weight gain in infants with hypoplastic left heart syndrome (HLHS) after stage 1 procedures.
In recent years, survival after neonatal cardiac surgery has improved significantly. As life
span has improved in HLHS/single ventricle variants (SVV) survivors, focus has shifted to
the understanding and management of associated health problems. Growth failure is a
well-recognized major co-morbidity in these patients.
Infants with HLHS/SVV demonstrate progressive growth failure after stage 1 procedures, which
appears to stabilize only after stage 2 procedures. Poor nutritional status increases risk
for post-operative infections, extends hospital length-of-stay, and adversely affects
neurodevelopmental outcomes.
To date, evidence-based feeding strategies that support adequate weight gain and improve
nutritional status have not been identified after stage 1 procedures. Continuous enteral
feeding regimens have resulted in improved growth in a diverse population of infants with
congenital heart disease and have been shown to decrease energy expenditure in premature
infants and adults. A randomized, controlled study of HLHS/SVV infants who underwent stage 1
procedures at a single medical center was conducted with the primary objective of comparing
weight gain at hospital discharge between infants receiving a continuous feeding regimen
versus an intermittent feeding regimen. Secondary objectives were to compare growth and
markers of nutritional status at hospital discharge between the two groups. The
investigators hypothesized that infants with HLHS/SVV who receive a continuous enteral
feeding regimen versus an intermittent feeding regimen will demonstrate improved weight
gain, growth, and nutritional status after stage 1 procedures at hospital discharge.
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Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Supportive Care
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