Effectiveness of High-Energy Density Enteral Nutrition for Enhancing Physical Growth and Cognitive Brain Development in Infants With Congenital Heart Disease

Inclusion Criteria:

• Diagnosed with congenital heart disease through symptoms, physical signs, imaging,and ultrasound examinations.

• Age 0-6 months

• Children with nutritional risks (defined by STRONGkids: Nutritional risk screeningtool for children )

• Artificial or mixed feeding

• Open heart surgery under cardiopulmonary bypass

• The guardians of the children voluntarily participate in this study and sign awritten informed consent form before the surgery.

Exclusion Criteria:

• Diagnosed with major non cardiac diseases leading to nutritional intake disorders,such as congenital gastrointestinal malformations, preoperative diagnosis ofgastroesophageal reflux, genetic diseases related to growth restriction, and varioussyndromes with chromosomal abnormalities (trisomy 21 syndrome, trisomy 18 syndrome)

• Abnormal immune system function due to congenital or acquired factors, unable toeffectively resist pathogens or eliminate abnormal cells, which can be divided intoprimary and secondary immunodeficiencies.

• Any pre - operative history of neurological diseases (e.g., encephalitis, epilepsy).

• Secondary or primary gastrointestinal infection symptoms such as abdominaldistension and diarrhea after surgery.

• Estimated stay time in the postoperative intensive care unit ≤ 2 days