Prospective Heart Rate Variability and Feeding Evaluation of Infants Undergoing Cardiac Surgery (Data Management Plan)

Neonatal cardiac surgery and postoperative care have made great advances in the last few decades. Challenges remain, however. The postop. Feeding difficulty is a significant problem that delays hospital discharge and predisposes this vulnerable population to nosocomial complications. Previous research has shown abnormal autonomic function as assessed by heart rate variability in the postoperative period. Studies have also shown abnormalities in the suck-swallow function. In this prospective study we aim to evaluate pre- and postoperative autonomic function as well as feeding pattern in patients under 6 months of age who required congenital heart surgery. 30 patients will be recruited and divided evenly in 3 groups in the ascending order of complexity of surgery. Group 1 includes surgeries that do not require cardiopulmonary bypass. Group 2 includes surgeries that do require cardiopulmonary bypass which is considered a medium complexity. Group 3 is the highest complexity group which requires cardiopulmonary bypass and deep hypothermic circulatory arrest. Patients will be evaluated for autonomic function and feeding function before and after surgery with a Holter monitor and pharyngoesophageal high-resolution manometry. For sucking function, a specialized nipple will be employed that measures various variables of tongue motion and sucking. A final Holter monitor will be placed 2 to 3 months after hospital discharge. The objective is to correlate abnormal autonomic function with dysphagia.