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The development of a consensus-based nutritional pathway for infants with CHD before surgery using a modified Delphi process

  • Luise V. Marino (a1) (a2), Mark J. Johnson (a2) (a3), Nigel J. Hall (a2) (a4) (a5), Natalie J. Davies (a1), Catherine S. Kidd (a1), M. Lowri Daniels (a1), Julia E. Robinson (a1), Trevor Richens (a5) (a6), Tara Bharucha (a5) (a6), Anne-Sophie E. Darlington (a7) and British Dietetic Association Paediatric Cardiology Interest Group...

Abstract

Introduction

Despite improvements in the medical and surgical management of infants with CHD, growth failure before surgery in many infants continues to be a significant concern. A nutritional pathway was developed, the aim of which was to provide a structured approach to nutritional care for infants with CHD awaiting surgery.

Materials and methods

The modified Delphi process was development of a nutritional pathway; initial stakeholder meeting to finalise draft guidelines and develop questions; round 1 anonymous online survey; round 2 online survey; regional cardiac conference and pathway revision; and final expert meeting and pathway finalisation.

Results

Paediatric Dietitians from all 11 of the paediatric cardiology surgical centres in the United Kingdom contributed to the guideline development. In all, 33% of participants had 9 or more years of experience working with infants with CHD. By the end of rounds 1 and 2, 76 and 96% of participants, respectively, were in agreement with the statements. Three statements where consensus was not achieved by the end of round 2 were discussed and agreed at the final expert group meeting.

Conclusions

Nutrition guidelines were developed for infants with CHD awaiting surgery, using a modified Delphi process, incorporating the best available evidence and expert opinion with regard to nutritional support in this group.

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Copyright

This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Corresponding author

Author for correspondence: Dr L. V. Marino, University Hospital Southampton NHS Foundation Trust, Southampton, S016 6YD, UK. Tel: +44 0 23 8079 6000; Fax: 023 8120 3086; E-mail: Luise.marino@uhs.nhs.uk

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