Abstract：
Infants with congenital heart disease (CHD) are at risk for developing both benign hematochezia and necrotizing enterocolitis (NEC). Despite these risks there are very few studies that investigate modifiable risk factors such as feeding practices. It remains unclear what feeding practices should be avoided due to higher incidence of CHD-NEC. We aim to assess the feeding practices across three high volume tertiary centers to establish a relationship between various feeding practices and development of NEC. A multicenter retrospective review of feeding practices at the time of documented hematochezia event that occurred between 1/2019 and 1/2021 in infants with CHD who were less than 6 months of age. NEC was defined as Bells Stage 2 or greater. Age, weight, ventricular morphology, primary diagnoses, feeding route, feed change, and formula type were evaluated. 176 hematochezia events occurred in 121 patients, 72% of these events were considered benign hematochezia with the remaining 28% being true NEC. Single ventricle (SV) physiology (p < 0.05), younger age, < 45 days of life, (p < 0.001), and feeding route were statistically associated with true NEC (p < 0.01). Formula type and recent change in feed administration were not associated with NEC. The caloric density of feeds at the time of hematochezia was nearing significance. The majority of hematochezia events are benign in nature, however, there should be heightened awareness in patients who are SV, younger in age, and those who are post-pylorically fed. There may be some risk in using higher caloric density feeds (> 24 kcal/oz), however, additional research is needed to fully establish this relationship.
摘要：
患有先天性心脏病（CHD）的婴儿有发生良性便血和坏死性小肠结肠炎（NEC）的风险。尽管存在这些风险，但很少有研究调查可修改的风险因素，例如喂养方式。由于CHD-NEC的发病率较高，因此尚不清楚应避免何种喂养方式。我们旨在评估三个高容量三级中心的喂养方式，以建立各种喂养方式与NEC发展之间的关系。在1/2019和1/2021之间发生的有记录的便血事件发生时喂养实践的多中心回顾性审查小于6个月的CHD婴儿。NEC被定义为钟声阶段2或更高。年龄,体重,心室形态,主要诊断,喂食路线,饲料变化，和公式类型进行了评估。121例患者发生了176例便血事件，这些事件中有72％被认为是良性便血，其余28％是真正的NEC。单心室（SV）生理（p<0.05），年龄较小,<45天的生活，（p<0.001），和喂养途径与真实NEC有统计学关联(p<0.01)。配方类型和最近的饲料施用变化与NEC无关。便血时饲料的热量密度接近重要。大多数便血事件本质上是良性的，然而,应该提高SV患者的意识，年龄更年轻，和那些幽门后喂养的人。使用较高热量密度的饲料（>24kcal/oz）可能存在一定风险，然而,需要更多的研究来充分建立这种关系。
