대한간호학회지 (Journal of Korean Academy of Nursing)

한국간호과학회 (Korean Society of Nursing Science)
권호 표지

심장수술 받은 영아의 영양중재프로그램 개발 및 적용

Development and Application of a Feeding Program for Infants Postoperatively following Cardiac Surgery

  • 문주령 (삼성서울병원 심장혈관센터) ;
  • 조용애 (삼성서울병원 간호교육팀) ;
  • 민선인 (삼성서울병원 흉부외과중환자실) ;
  • 양지혁 (성균관의대 흉부외과) ;
  • 허준 (성균관의대 소아청소년과) ;
  • 정연이 (삼성서울병원 진료개선팀)
  • Moon, Ju-Ryoung (Cardiac & Vascular Center, Samsung Medical Center) ;
  • Cho, Yong Ae (Nursing Staff Development, Samsung Medical Center) ;
  • Min, Sun-In (Cardiac Intensive Care Unit, Samsung Medical Center) ;
  • Yang, Ji-Hyuk (Thoracic and Cardiovascular Surgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University) ;
  • Huh, June (Department of Pediatrics, Samsung Medical Center, School of Medicine, Sungkyunkwan University) ;
  • Jung, Yeon-Yi (Clinical Quality Improvement Team, Samsung Medical Center)
  • 발행 : 2009.08.28
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Purpose: Despite recent advances in the surgical and postoperative management of infants with congenital heart disease, nutritional support for this population is often suboptimal. The purpose of this study was to develop a nutritional program for the postoperative period for infants who have had cardiac surgery and to evaluate effects of the program. Methods: A quasi-experimental design with pretest and posttest measures was used. A newly developed nutritional program including a feeding protocol and feeding flow was provided to the study group (n=19) and usual feeding care to the control group (n=19). The effects of the feeding program were analyzed in terms of total feed intake, total calorie intake, gastric residual volume, and frequency of diarrhea. Results: Calorie intake and feeding amount in the study group were significantly increased compared to the control group. However, the two groups showed no significant differences in gastric residual volume and frequency of diarrhea. Conclusion: The results indicate that the nutritional program used in the study is an effective nursing intervention program in increasing feeding amount and calorie intake in infants postoperative to cardiac surgery and does not cause feeding-related complications.

키워드

참고문헌

  1. American Academy of Pediatrics Committee on Nutrition. (1998). Pediatric Nutrition Handbook (4th ed.). Elk Grove Village, IL:American Academy of Pediatrics
  2. Beke, D. M., Braudis, N. J., & Lincolin, P. (2005). Management of the pediatric postoperative cardiac surgery patient. Critical Care Nursing Clinics of North America, 17, 405-416 https://doi.org/10.1016/j.ccell.2005.08.006
  3. Chan, R., Jacobs, S., & Lee, B. (1987). Gastrointestinal dysfunction among intensive care patients. Critical Care Medicine, 10, 909-914 https://doi.org/10.1097/00003246-198710000-00003
  4. Ciotti, G., Holzer, R., Pozzi, M., & Dalzell, M. (2002). Nutritional support via percutaneous endoscopic gastrostomy in children with cardiac disease experiencing difficulties with feeding. Cardiology in the Young, 12, 537-541 https://doi.org/10.1017/S1047951102000975
  5. Davey, A. M., Wagner, C. L., Cox, C., & Kendig, J. W. (1994). Feeding premature infants while low umbilical artery catheters are in place: A prospective, randomized trial. Journal of Pediatrics, 124, 795-799 https://doi.org/10.1016/S0022-3476(05)81376-9
  6. De Jonghe, B., Appere-De-Vechi, C., Fournier, M., Tran, B., Merrer, J., Melchior, J. P., et al. (2001). A Prospective survey of nutritional support practices in intensive care unit patient: What is prescribed? What is delivered? Critical Care Medicine, 29, 8-12 https://doi.org/10.1097/00003246-200101000-00002
  7. Frankenfield, D. C., Smith, J. S., & Cooley, R. N. (1997). Accelerated nitrogen loss after traumatic injury is not attenuated by achievement of energy balance. Journal of Parenteral and Enteral Nutrition, 21, 324-329 https://doi.org/10.1177/0148607197021006324
  8. Hanekamp, M. N., Spoel, M., Sharman-Koendjbiharie, I., Jeroen, W. B., Albers, M. J., & Tibboel, D. (2005). Routine enteral nutrition in neonates on extracorporeal membrane oxygenation. Pediatric Critical Care Medicine, 6, 275-279 https://doi.org/10.1097/01.PCC.0000161620.86647.72
  9. Kim, J. E., Choi, B. H., Kim, K. M., Ko, J. K., & Seo, D. M. (2001). Analysis of malnutrition in children with congenital heart disease. Korean Journal of Pediatrics, 44, 161-165
  10. Kinney, J. M. (1995). Metabolic responses of the critically ill patient. Critical Care Clinics, 11, 569-585
  11. Lee, S. I., & Choi, H. R. (2003). Nutrition for infants and children. Seoul: Kyomunsa
  12. McCulley, M. E., Jeffries, H. E., Wells, W. J., Starnes, V. A., Castil-lo, S. L., Moromisato, D. Y., et al. (2005). Effect of a standardized feeding protocol in infants with hypoplastic left ventricle following first stage palliation. Critical Care Medicine, 33, A62
  13. Moon, J. R., Huh, J., Lee, H. J., Kang, I. S., Kim, S. H., & Jun, T. G. (2006, April). Diagnosis of feeding difficulty and development of feeding protocol after cardiac surgery in infant. Paper presented at the annual meeting of the Korean Society of Quality Assurance in the Health Care, Jeju
  14. Ngdegger, A., & Eines, E. (2006). Energy metabolism in infants with congenital heart disease. Nutrition, 22, 697-704 https://doi.org/10.1016/j.nut.2006.03.010
  15. Petrillo-Albarano, T., Pettignano, R., Asfaw, M., & Easley, K. (2006). Use of a feeding protocol to improve nutritional support through early, aggressive, enteral nutrition in the pediatric intensive care unit. Pediatric Critical Care Medicine, 7, 340-344 https://doi.org/10.1097/01.PCC.0000225371.10446.8F
  16. Pillo-Blocka, F., Aditia, I., & Sharieff, W. (2004). Rapid advancement to more concentrated formula in infants after surgery for congenital heart disease reduces duration of hospital stay: A randomized clinical trial. Journal of Pediatrics, 145, 761-766 https://doi.org/10.1016/j.jpeds.2004.07.043
  17. Rogers, B., & Arvedson, J. (2005). Assessment of infant oral sensorimotor and swallowing function. Mental Retardation and Developmental Disabilities, 35, 74-82 https://doi.org/10.1002/mrdd.20055
  18. Samour, P. Q., Helm, K. K., & Lang, C. E. (1999). Handbook of pediatric nutrition (2nd ed.). Baltimore, MD: Aspen Publication
  19. Sanchez, C., Lopez-Herce, J., Carrillo, A., Bustinza, A., Sancho, L., & Vigil, D. (2006). Transpyloric enteral feeding in the postoperative of cardiac surgery in children. Pediatric Surgery, 41, 1096-1102 https://doi.org/10.1016/j.jpedsurg.2006.02.010
  20. Sinden, A. A., & Sutphen, J. L. (1995). Growth and nutrition, In J. W. Pine (Ed.). Moss and Adams’ heart disease in infants, children, and adolescent: Including the fetus and young adult (pp 366-374). Baltimore, MD: Williams & Wilkins
  21. Steltzer, M., Rudd, N., & Pick, B. (2005). Nutrition care for newborns with congenital heart disease. Clinics in Perinatology, 32, 1017-1030 https://doi.org/10.1016/j.clp.2005.09.010
  22. Verhoeven, J. J., Hazelzet, J. A., van der Voort, E., & Joosten, K. F. (1998). Comparison of measured and predicted energy expenditure in mechanically ventilated children. Intensive Care Medicine, 24, 464-468 https://doi.org/10.1007/s001340050597
  23. Wall, R. J., Dittus, R. S., & Ely, E. W. (2001). Protocol-driven care in the intensive care unit: A tool for quality. Critical Care, 5, 283-285 https://doi.org/10.1186/cc1048