High-Energy Nutrition in Hospitalised Paediatric Patients With Congenital Heart Disease: A Systematic Review and Meta-Analysis

Abstract

Background: Congenital heart disease (CHD) is a significant cause of growth failure and neonatal mortality worldwide, and requirement-focused nutritional management can deeply impact the prognosis [1]. Despite multiple trials, there is no published meta-analysis on the impact of high-energy nutrition in this population. Methods: We searched PubMed, Embase and Cochrane Central for RCTs comparing high-energy to standard formulas in hospitalised patients. We computed mean differences (MDs) for continuous outcomes and odds ratios (ORs) for binary endpoints, with 95% confidence intervals (CIs). Results: Five studies comprising 276 patients were included, of whom 139 (50.4%) received the high-energy formula. Compared with the standard, they had higher weight gain (MD 276.37; 95% CI 56.29, 496.46) and energy intake (MD 22.33; 95% CI 7.59, 37.07). Despite no statistical significance, the length of hospital stay (MD -3.51; 95% CI -7.33, 0.3) tends to be shorter. There were no significant differences regarding the length of ICU stay (MD -10.32; 95% CI -58.04, 37.40) and mechanical ventilation (MD -19.54; 95% CI -47.81, 8,73). The presence of side effects (OR 1.82; 95% CI 0.58, 5.7; p=0.3) was one of the outcomes most reported as better in the control group, but overall, there's no significant difference. Conclusion: Our findings suggest the high-energy formula may be superior to control considering weight gain and energy intake. In addition, the presence of side effects has not been significantly different between groups. Reference: [1] Luca, A.-C. et al. Optimal Nutrition Parameters for Neonates and Infants with Congenital Heart Disease. Nutrients 14, 1671 (2022).