ArticleFrontiers in rehabilitation sciences2026
Impact of a unit-wide feeding tolerance management protocol on enteral feeding outcomes in infants with congenital heart disease: a pre-post quality improvement cohort study.
Article in Frontiers in rehabilitation sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Infants recovering from congenital heart disease (CHD) surgery frequently experience feeding intolerance (FI), a major barrier to achieving adequate enteral nutrition (EN). This pre-post quality improvement study evaluated whether implementation of a standardized feeding-tolerance management pathway was associated with improved consistency of EN monitoring and corresponding trends in FI-related outcomes. Methods: A single-center, consecutively enrolled quality improvement cohort included postoperative CHD infants admitted in 2022 (pre-implementation) and 2023 (post-implementation). The intervention consisted of unit-wide standardization of FI risk assessment, EN monitoring indicators, alert-trigger criteria, and documentation procedures. No feeding strategy was altered. The primary outcome was FI incidence; secondary outcomes included time to full EN, gastrointestinal symptoms, EN interruptions, and nutritional status. Statistical analyses included Results: A total of 301 infants were analyzed (148 pre-implementation; 153 post-implementation). Documentation completeness increased from 68.4% to 91.7%, and adherence to predefined alert criteria rose from 54.7% to 92.2% (both Conclusions: Implementation of a standardized feeding-tolerance pathway was associated with improved monitoring consistency and favorable trends in FI incidence, EN progression, and in-hospital nutritional stability among postoperative CHD infants.
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