Effect of standardized vs. local preoperative enteral feeding practice on the incidence of NEC in infants with duct dependent lesions: Protocol for a randomized control trial

Joanna Seliga-Siwecka; Ariel Płotko; Agata Wójcik-Sep; Renata Bokiniec; Julita Latka-Grot; Małgorzata Żuk; Konrad Furmańczyk; Wojciech Zieliński; Mariola Chrzanowska

doi:10.3389/fcvm.2022.893764

Effect of standardized vs. local preoperative enteral feeding practice on the incidence of NEC in infants with duct dependent lesions: Protocol for a randomized control trial

Front Cardiovasc Med. 2022 Sep 8:9:893764. doi: 10.3389/fcvm.2022.893764. eCollection 2022.

Authors

Affiliations

¹ Department of Neonatology and Neonatal Intensive Care, Medical University of Warsaw, Warsaw, Poland.
² Department of Neonatology, Children's Health Memorial Institute, Warsaw, Poland.
³ Cardiology Clinic, Children's Health Memorial Institute, Warsaw, Poland.
⁴ Department of Applied Mathematics, Institute of Information Technology, Warsaw University of Life Sciences, Warsaw, Poland.
⁵ Department of Prevention of Environmental Hazards, Allergology and Immunology, Medical University of Warsaw, Warsaw, Poland.
⁶ Department of Statistics and Econometrics, Institute of Economics and Finance, Warsaw University of Life Sciences, Warsaw, Poland.

Abstract

Background: Infants with duct dependent heart lesions often require invasive procedures during the neonatal or early infancy period. These patients remain a challenge for pediatric cardiologists, neonatologists, and intensive care unit personnel. A relevant portion of these infant suffer from respiratory, cardiac failure and may develop NEC, which leads to inadequate growth and nutrition, causing delayed or complicated cardiac surgery.

Methods: This randomized control trial will recruit term infants diagnosed with a duct dependant lesion within the first 72 h of life. After obtaining written parental consent patients will be randomized to either the physician led enteral feeding or protocol-based feeding group. The intervention will continue up to 28 days of life or day of cardiosurgical treatment, whichever comes first. The primary outcomes include NEC and death related to NEC. Secondary outcomes include among others, number of interrupted feedings, growth velocity, daily protein and caloric intake, days to reach full enteral feeding and on mechanical ventilation.

Discussion: Our study will be the first randomized control trial to evaluate if standard (as in healthy newborns) initiation and advancement of enteral feeding is safe, improves short term outcomes and does not increase the risk of NEC. If the studied feeding regime proves to be intact, swift implementation and advancement of enteral nutrition may become a recommendation.

Trial registration: The study protocol has been approved by the local ethical board. It is registered at ClinicalTrials.gov NCT05117164.

Keywords: congenital heart defect; duct dependant; enteral feeding algorithm; intensive care unit; neonate.

Associated data

ClinicalTrials.gov/NCT05117164