AUTHOR=Seliga-Siwecka Joanna , Płotko Ariel , Wójcik-Sep Agata , Bokiniec Renata , Latka-Grot Julita , Żuk Małgorzata , Furmańczyk Konrad , Zieliński Wojciech , Chrzanowska Mariola 

TITLE=Effect of standardized vs. local preoperative enteral feeding practice on the incidence of NEC in infants with duct dependent lesions: Protocol for a randomized control trial

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.893764

DOI=10.3389/fcvm.2022.893764

ISSN=2297-055X

ABSTRACT=Background: Infants with duct dependent heart lesions often require invasive procedures during the neonatal or early infancy period. These patients remain a challenge for paediatric cardiologists, neonatologists, and intensive care unit personnel.  A relevant portion of these infant suffer from respiratory and cardiac failure which leads to inadequate growth and nutrition, causing delayed or complicated cardiac surgery.
Methods: This randomized control trial will recruit term infants diagnosed with a duct dependant lesion within the first 72 hours of life. After obtaining written parental consent patients will be randomised to either the physician led enteral feeding or protocol-based feeding group. The intervention will continue up to 28 days of life or day of cardiosurgical treatment, whichever comes first. The primary outcome measure is necrotizing enterocolitis and or death. Secondary outcomes include among others, number of interrupted feedings, growth velocity, daily protein and caloric intake, days to reach full enteral feeding and on mechanical ventilation.
Discussion: Our study will be the first randomized control trial to evaluate if standard (as in healthy newborns) initiation and advancement of enteral feeding is safe, improves short term outcomes and does not increase the risk of NEC. If the studied feeding regime proves to be intact, swift implementation and advancement of enteral nutrition may become a recommendation.   
Trial registration: The study protocol has been approved by the local ethical board. It is registered at ClinicalTrials.gov NCT05117164.