Nutrition in the Cardiac Critical Care Unit

Nutrition is an integral component of supportive care for childrenChildren with congenital heart diseaseCongenital heart disease (CHD). Nutrition interventions aim to prevent or reduce malnutrition and growth impairment, which are associated with adverse outcomes. Adequacy of macro and micronutrient delivery is monitored, as well as feeding tolerance, biochemistry, and anthropometric measures to ensure adequate nutrients are provided in response to a patient’s medical stability or growth requirements. Enteral nutritionEnteral nutrition is the preferred mode of nutrition delivery for acute and chronic conditions. Feeds are initiated within 24 hours of hospital and critical care admission, whenever possible, and escalated to meet a patient’s metabolic demand. Feeds can be delivered by bolus or continuous basis, or via gastric and postpyloric routes for potentially improved tolerance. Parenteral nutritionParenteral nutrition is used as a supplemental or sole source of nutrition support in patients unable to receive enteral feeds. Alternative nutrition strategies exist for those with prematurityPrematurity, necrotizing enterocolitisNecrotizing enterocolitis, chylothoraxChylothorax, gastrointestinal abnormalities, acute kidney injury or mechanical circulatory support.