Standardized Feeding Approach Mitigates Weight Loss in Infants with Congenital Heart Disease.

OBJECTIVE: To evaluate the effect of a standardized feeding approach using a clinical nutrition pathway on weight-for-age Z score (WAZ) over hospital length of stay (HLOS) for infants with congenital heart disease (CHD). STUDY DESIGN: A 10-year retrospective cohort study examined eligible infants who underwent neonatal cardiac surgery between July 2009 and December 2018 (n = 987). Eligibility criteria included infants born at least 37 weeks of gestation and a minimum birth weight of 2 kg who underwent cardiac surgery for CHD within the first 30 days of life. Using the best linear unbiased predictions from a linear mixed effects model, WAZ change over HLOS was estimated before and after January 2013, when the standardized feeding approach was initiated. The best linear unbiased predictions model included adjustment for patient characteristics including sex, race, HLOS, and class of cardiac defect. RESULTS: The change in WAZ over HLOS was significantly higher from 2013 to 2018 than from 2009 to 2012 (ß = 0.16; SE = 0.02; P < .001), after controlling for sex, race, HLOS, and CHD category, indicating that infants experienced a decreased WAZ loss over HLOS after the standardized feeding approach was initiated. Additionally, differences were found in WAZ loss over HLOS between infants with single ventricle CHD (ß = 0.26; SE = 0.04; P < .001) and 2 ventricle CHD (ß = 0.04; SE = 0.02; P = .04). CONCLUSIONS: These data suggest that an organized, focused approach for nutrition therapy using a standardized pathway improves weight change outcomes before hospital discharge for infants with single and 2 ventricle CHD who require neonatal cardiac surgery.

Influence of mashed potato dielectric properties and circulating water electric conductivity on radio frequency heating at 27 MHz.

Experiments and computer simulations were conducted to systematically investigate the influence of mashed potato dielectric properties and circulating water electric conductivity on electromagnetic field distribution, heating rate, and heating pattern in packaged food during radio frequency (RF) heating processes in a 6 kW, 27 MHz laboratory scale RF heating system. Both experimental and simulation results indicated that for the selected food (mashed potato) in this study, the heating rate decreased with an increase of electric conductivity of circulating water and food salt content. Simplified analytical calculations were carried out to verify the simulation results, which further indicated that the electric field distribution in the mashed potato samples was also influenced by their dielectric properties and the electric conductivity of the surrounding circulating water. Knowing the influence of water electric conductivity and mashed potato dielectric properties on the heating rate and heating pattern is helpful in optimizing the radio frequency heating process by properly adjusting these factors. The results demonstrate that computer simulation has the ability to demonstrate influence on RF heat pattern caused by the variation of material physical properties and the potential to aid the improvement on construction and modification of RF heating systems.