Hanyang Med Rev.  2011 Nov;31(4):235-239. 10.7599/hmr.2011.31.4.235.

Perioperative Nutritional Management in Cardiac Surgery

  • 1Department of Thoracic & Cardiovascular Surgery, Chungbuk National University College of Medicine, Cheongju, Korea. hongjm@chungbuk.ac.kr


Perioperative nutritional status is an important factor for the prognosis of cardiac surgery. Preoperatively debilitated or cachectic patients (i.e., more than 10% weight loss over 6 months) with decreased albumin level are exceptionally prone to complications, such as infections following surgery. For better support of the perioperative nutritional intake, exact preoperative monitoring of nutritional status and supplement of essential nutritional factors are necessary for cardiac patients. I will describe here the nutritional states assessment and monitoring methods of infants with congenital heart diseases and consider essential nutritional factors in patients with heart disease. For the conditions where enteral nutrition is not possible, postoperative control of blood sugar is important, or special nutritional considerations for heart disease patients is needed. I will discuss the clinical problems related to these conditions and suggest possible methods of improvement for each condition.


Heart Diseases; Nutrition Disorders; Nutrition Assessment; Nutrition Therapy

MeSH Terms

Blood Glucose
Enteral Nutrition
Heart Diseases
Nutrition Assessment
Nutrition Disorders
Nutrition Therapy
Nutritional Status
Thoracic Surgery
Weight Loss
Blood Glucose


1. Leite HP, Fisberg M, de Carvalho WB, de Camargo Carvalho AC. Serum albumin and clinical outcome in pediatric cardiac surgery. Nutrition. 2005. 21:553–558.
2. Fritz HG, Brandes H, Bredle DL, Bitterlich A, Vollandt R, Specht M, et al. Post-operative hypoalbuminaemia and procalcitonin elevation for prediction of outcome in cardiopulmonary bypass surgery. Acta Anaesthesiol Scand. 2003. 47:1276–1283.
3. Raguso CA, Dupertuis YM, Pichard C. The role of visceral proteins in the nutritional assessment of intensive care unit patients. Curr Opin Clin Nutr Metab Care. 2003. 6:211–216.
4. Lim SH, Lee JS, Chae SH, Ahn BS, Chang DJ, Shin CS. Prealbumin is not sensitive indicator of nutrition and prognosis in critical ill patients. Yonsei Med J. 2005. 46:21–26.
5. Koletzko B, Goulet O, Hunt J, Krohn K, Shamir R. 1. Guidelines on Paediatric Parenteral Nutrition of the European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and the European Society for Clinical Nutrition and Metabolism (ESPEN), Supported by the European Society of Paediatric Research (ESPR). J Pediatr Gastroenterol Nutr. 2005. 41:Suppl 2. S1–S87.
6. Norris MK, Hill CS. Nutritional issues in infants and children with congenital heart disease. Crit Care Nurs Clin North Am. 1994. 6:153–163.
7. Wintergerst KA, Buckingham B, Gandrud L, Wong BJ, Kache S, Wilson DM. Association of hypoglycemia, hyperglycemia, and glucose variability with morbidity and death in the pediatric intensive care unit. Pediatrics. 2006. 118:173–179.
8. ASPEN Board of Directors and the Clinical Guidelines Task Force. Guidelines for the use of parenteral and enteral nutrition in adult and pediatric patients? JPEN J Parenter Enteral Nutr. 2002. 26:1SA–138SA.
9. Willis L, Thureen P, Kaufman J, Wymore E, Skillman H, da Cruz E. Enteral feeding in prostaglandin-dependent neonates: is it a safe practice? J Pediatr. 2008. 153:867–869.
10. Sanchez C, Lopez-Herce J, Carrillo A, Bustinza A, Sancho L, Vigil D. Transpyloric enteral feeding in the post-operative of cardiac surgery in children. J Pediatr Surg. 2006. 41:1096–1102.
11. Lee JH, O'Keefe JH, Bell D, Hensrud DD, Holick MF. Vitamin D deficiency an important, common, and easily treatable cardiovascular risk factor? J Am Coll Cardiol. 2008. 52:1949–1956.
12. Munoz R, Laussen PC, Palacio G, Zienko L, Piercey G, Wessel DL. Whole blood ionized magnesium: age-related differences in normal values and clinical implications of ionized hypomagnesemia in patients undergoing surgery for congenital cardiac disease. J Thorac Cardiovasc Surg. 2000. 119:891–898.
13. Manrique AM, Arroyo M, Lin Y, El Khoudary SR, Colvin E, Lichtenstein S, et al. Magnesium supplementation during cardiopulmonary bypass to prevent junctional ectopic tachycardia after pediatric cardiac surgery: a randomized controlled study. J Thorac Cardiovasc Surg. 2010. 139:162–169.e2.
14. Aneja RK. Zinc-Jack of all trades, master of none! Pediatr Crit Care Med. 2009. 10:129–131.
15. Heyland DK, Jones N, Cvijanovich NZ, Wong H. Zinc supplementation in critically ill patients: a key pharmaconutrient? JPEN J Parenter Enteral Nutr. 2008. 32:509–519.
16. Shi SS, Shi CC, Zhao ZY, Shen HQ, Fang XM, Tan LH, et al. Effect of open heart surgery with cardiopulmonary bypass on peripheral blood lymphocyte apoptosis in children. Pediatr Cardiol. 2009. 30:153–159.
17. Wischmeyer PE. Glutamine: mode of action in critical illness. Crit Care Med. 2007. 35:S541–S544.
18. Novak F, Heyland DK, Avenell A, Drover JW, Su X. Glutamine supplementation in serious illness: a systematic review of the evidence. Crit Care Med. 2002. 30:2022–2029.
19. Tubman TR, Thompson SW, McGuire W. Glutamine supplementation to prevent morbidity and mortality in preterm infants. Cochrane Database Syst Rev. 2008. CD001457.
20. Carcillo J, Holubkov R, Dean JM, Berger J, Meert KL, Anand KJ, et al. Rationale and design of the pediatric critical illness stress-induced immune suppression (CRISIS) prevention trial. JPEN J Parenter Enteral Nutr. 2009. 33:368–374.
21. Huang Y, Shao XM, Neu J. Immunonutrients and neonates. Eur J Pediatr. 2003. 162:122–128.
22. Buttiker V, Fanconi S, Burger R. Chylothorax in children: guidelines for diagnosis and management. Chest. 1999. 116:682–687.
23. Wooley JA, Btaiche IF, Good KL. Metabolic and nutritional aspects of acute renal failure in critically ill patients requiring continuous renal replacement therapy. Nutr Clin Pract. 2005. 20:176–191.
Full Text Links
  • HMR
export Copy
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr