Parenteral nutrition

Abstract

Growth failure is common in infants born with congenital heart disease and malnutrition among patients with complex heart disease has been estimated to be as high as 53 % [ 25 ]. Poor nutrition is associated with worse outcomes in children undergoing surgery and those with critical illness. Any neonate undergoing cardiopulmonary bypass (CPB) experiences a more profound metabolic response to stress than seen in older children and adults. This puts the neonate at a higher risk for morbidity, organ dysfunction and postoperative complications. The care of the neonate after cardiac surgery is heterogeneous and complex. Nutrition plays a vital role in preserving body mass, promoting wound healing, and growth. This chapter is written to provide general guidelines for delivering safe total parenteral nutrition (TPN) in the cardiac patient. It includes a discussion on how to estimate parenteral nutrition and fluid goals; types of access; initiation and advancement; complications; and safe transition off TPN.