Determinants of adherence to preoperative oral carbohydrates and short-term outcomes in pediatric congenital pulmonary airway malformation

This study aimed to assess adherence to preoperative oral carbohydrate (CHO) supplementation among pediatric patients undergoing thoracoscopic resection for congenital pulmonary airway malformation (CPAM), and to explore potential influencing factors as well as statistical correlations between supplementation adherence and short-term postoperative outcomes. This observational study consecutively enrolled 110 pediatric patients diagnosed with CPAM who received a standardized preoperative oral carbohydrate protocol. Adherence rate was calculated using the formula: (actual consumed volume/prescribed volume) × 100%. Multivariable linear regression models were applied to screen independent predictors of supplementation adherence. Spearman’s rank correlation and multiple linear regression analyses were further performed to test statistical correlations between adherence and short-term postoperative outcomes. Preoperative CHO supplementation demonstrated good tolerance overall, with CHO-associated adverse events documented in 3.6% (4/110) of enrolled patients. The median adherence rate reached 80%, reflecting that most pediatric patients consumed most of the prescribed CHO solution. Nevertheless, merely nearly half of the participants attained the predefined exploratory cutoff value of adherence ≥ 80%. Independent positive predictors of adherence were identified as later surgical sequence, low nutritional risk screening score, and active parental care. Higher adherence levels presented a positive linear correlation with elevated caregiver satisfaction scores and fewer episodes of postoperative hunger-induced crying. Preoperative oral carbohydrate supplementation may optimize the perioperative experience for pediatric patients with CPAM and showed acceptable feasibility within this study cohort. Adjusting surgical schedules to arrange operations at later time points, implementing targeted interventions for patients at elevated nutritional risk, and strengthening parent-guided care strategies may help elevate treatment adherence. Elevated adherence was statistically associated with fewer postoperative hunger-induced crying episodes and higher caregiver satisfaction scores.