ArticleBMC pediatrics2026
Impact of early postoperative enteral nutrition initiation timing on infection rate and nutritional status in children with congenital heart disease.
Article in BMC pediatrics, 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
backgroundThe optimal timing for initiating enteral nutrition after congenital heart disease surgery remains controversial. This study aimed to evaluate the impact of early versus delayed enteral nutrition initiation on postoperative infection rate and nutritional status in pediatric congenital heart disease patients.
methodsA retrospective cohort study was conducted on 246 children (aged 1 month to 3 years) who underwent congenital heart disease surgery between January 2021 and December 2023. Patients were divided into early enteral nutrition group (enteral nutrition initiated ≤ 24 h postoperatively, n = 128) and delayed enteral nutrition group (enteral nutrition initiated > 24 h postoperatively, n = 118). Primary outcomes included postoperative infection rate and nutritional parameters. Secondary outcomes included ICU length of stay, hospital length of stay, and mechanical ventilation duration.
resultsThe early enteral nutrition group demonstrated significantly lower nosocomial infection rate (14.84% vs. 27.12%, P = 0.016) and surgical site infection rate (3.91% vs. 10.17%, P = 0.047). Postoperative day 7 serum albumin (35.62 ± 4.18 vs. 32.47 ± 5.23 g/L, P < 0.001) and prealbumin levels (168.35 ± 42.67 vs. 142.58 ± 38.94 mg/L, P < 0.001) were significantly higher in the early enteral nutrition group. The early enteral nutrition group also showed shorter ICU stay (5.38 ± 2.14 vs. 7.25 ± 3.42 days, P < 0.001) and hospital stay (12.45 ± 4.36 vs. 16.82 ± 5.78 days, P < 0.001). Multivariate logistic regression identified delayed enteral nutrition initiation as an independent risk factor for nosocomial infection (OR = 2.18, 95% CI: 1.12-4.24, P = 0.022).
conclusionsIn this retrospective cohort study, early enteral nutrition initiation within 24 h after congenital heart disease surgery was associated with reduced infection rates, improved nutritional status, and shorter hospital stay in pediatric patients, predominantly those undergoing repair of septal defects. These observations suggest a potential benefit of early enteral nutrition in selected pediatric cardiac surgery patients; however, prospective validation is warranted before broad implementation, given the inherent limitations of the retrospective design and the predominantly lower-complexity patient population studied.
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