Optimal nutritional therapy is important for infants and children with perioperative congenital heart disease and heart failure. Medical providers face physiological and metabolic challenges when administering enteral and parenteral nutrition to these patients. Complications related to enteral nutrition can increase morbidity and mortality, although outcomes are improved in those cases in which caloric and nutrient administration can be achieved. Consensus regarding feeding strategies and timing of nutritive care is lacking. This narrative review aims to summarize, analyze and discuss the most recent literature on nutritional therapy in perioperative congenital heart disease, heart failure and pediatric patients requiring mechanical circulatory support in the intensive care unit. We also present our own institution's enteral feeding protocols and rationale for their use supported by evidence-based medicine.
Keywords: cardiac necrotizing enterocolitis; congenital heart disease; enteral nutrition; extracorporeal membrane oxygenation; indirect calorimetry; parenteral nutrition; resting energy expenditure; ventricular assist device.