Percutaneous gastrostomy tubes in children with Pierre Robin sequence: efficacy, maintenance and complications

Al-Attar, Hyder; Shergill, Arvind K; Brown, Nicole; Guernsey, Cindy; Fisher, David M.; Temple, Michael; John, Philip; Amaral, João; Parra, Dimitri A.; Connolly, Bairbre

doi:10.1007/s00247-011-2301-2

Cited by 10 publications

(10 citation statements)

References 29 publications

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“…This finding is consistent with previous findings in infants with congenital diaphragmatic hernia, in which G‐tubes were not associated with improved growth . Nevertheless, in populations with special medical conditions that predispose to poor growth and nutrition such as ultrashort gut, Pierre Robin syndrome, and cystic fibrosis, G‐tube placement has been associated with improved weight gain …”

Section: Discussionsupporting

confidence: 91%

“…9 Nevertheless, in populations with special medical conditions that predispose to poor growth and nutrition such as ultrashort gut, Pierre Robin syndrome, and cystic fibrosis, Gtube placement has been associated with improved weight gain. [10][11][12] Children with neurodevelopmental disabilities have been the most studied population, with apparent long-term benefits of growth and quality of life associated with G-tube placement. [13][14][15][16] Weight gain and appropriate growth occur more frequently in this population when G-tube placement occurs early, before morbidities and malnutrition become evident.…”

Section: Discussionmentioning

confidence: 99%

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Impact of Gastrostomy Tube Placement on Short‐Term Weight Gain in Hospitalized Premature Infants

Puia‐Dumitrescu

Benjamin

Smith

et al. 2019

J Parenter Enteral Nutr

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Background Gastrostomy tube (G‐tube) placement is a long‐term alternative to oral or nasogastric feeding for premature infants who cannot safely feed orally or need supplemental nutrition for adequate growth. Methods We compared daily weight changes for G‐tube infants 14 and 30 days preplacement and postplacement, excluding the first 7 days post–G‐tube insertion. Infants <37 weeks of gestation without major congenital anomalies and discharged from 327 United States neonatal intensive care units (2004–2013) were included. Incidence of in‐hospital outcomes including hypoxic ischemic encephalopathy, intraventricular hemorrhage grade 3 or 4, necrotizing enterocolitis, and patent ductus arteriosus ligation was examined. Additionally, we estimated a treatment effect model in which infants with a G‐tube were matched 1:1 to untreated controls based on propensity scores; main outcome was the average treatment effect (weight gain) for treated infants during the 7, 14, or 30 days immediately prior to discharge. Results Of 329,254 infants, 1393 (0.4%) received a G‐tube, increasing from 0.2% in 2004 to 0.6% in 2013. Daily weight gain was significantly less during days 8–14 postplacement compared with 14 days preplacement but was similar between 30 days preplacement and 8–30 days postplacement. After matching, G‐tube infant weight gain during the 7 days predischarge was less than among controls, but there was no difference in weight gain between treated and control patients for 14 days and 30 days predischarge. Conclusions The prevalence of G‐tube placement has increased. G‐tube use in infants was not associated with improved short‐term daily weight gain.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Impact of Gastrostomy Tube Placement on Short‐Term Weight Gain in Hospitalized Premature Infants

Puia‐Dumitrescu

Benjamin

Smith

et al. 2019

J Parenter Enteral Nutr

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“…Adequately addressing respiratory symptoms in these infants can lead to an improvement in nutritional and caloric intake. In parallel to other reports of feeding parameters, this study of G-tube rates is particularly informative given the more invasive nature of gastrostomies compared to other means of supplemental feeding and the comprehensive comparison of interventions 17,18 . Of the operative interventions, MDO was associated with the lowest G-tube rate.…”

Section: Discussionmentioning

confidence: 95%

“…For those with prolonged oral feeding impairment, a gastrostomy tube (G-tube) is placed. G-tube placement requires an operation and exposes the patient to additional risk 17,18 .…”

mentioning

confidence: 99%

A comparison of airway interventions and gastrostomy tube placement in infants with Robin sequence

Ghoul

Calabrese

Resnick

2020

International Journal of Oral and Maxillofacial Surgery

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The purpose of this study was to evaluate feeding impairment following non-operative or operative management of airway obstruction in a large series of infants with Robin sequence (RS) by rate of G-tube placement. A retrospective study was conducted at Boston Children's Hospital including 225 patients (47.1% female) with RS treated between 1976 and 2018. Subjects were grouped by intervention required for successful management of airway obstruction: nonoperative only (n = 120), tongue-lip adhesion (TLA, n = 75), mandibular distraction osteogenesis (MDO, n = 21), or tracheostomy (n = 9). The operative group had a higher rate of G-tube placement (58.1%) than the non-operative group (28.3%, P < 0.0001). Subjects in the TLA and tracheostomy groups had higher odds of G-tube placement than subjects in the MDO group: odds ratio (OR) 5.5 (95% confidence interval (CI) 1.8-17.3, P = 0.004) and OR 27.0 (95% CI 3.2-293.4, P = 0.007), respectively. Syndromic patients and those with gastrointestinal anomalies also had higher odds of G-tube placement: OR 3.5 (95% CI 1.7-7.2, P = 0.001) and OR 5.9 (95% CI 1.6-21.0, P = 0.007), respectively. Infants with RS who require an airway operation and those with a syndromic diagnosis or gastrointestinal anomalies are more likely to require placement of a G-tube. Of the operative groups, MDO was associated with the lowest G-tube rate, compared to TLA and tracheostomy.

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“…Infants and children with Pierre Robin sequence cannot adequately feed by mouth due to their mandibular anatomy. In a study of 37 children with Pierre Robin sequence, 32% had a weight increase after G-tube placement while another 43% maintained their weight [14]. A cohort of pediatric cystic fibrosis patients showed improved weight gain one and two years after G-tube placement, especially in those individuals with G-tube feedings for >6 months and mild CF.…”

Section: Discussionmentioning

confidence: 99%

Gastrostomy tube placement in infants with congenital diaphragmatic hernia: Frequency, predictors, and growth outcomes

Rudra

Adibe

Malcolm

et al. 2016

Early Human Development

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Background Gastrostomy tube (G-tube) placement is a common intervention for newborns with severe feeding difficulties. Infants with congenital diaphragmatic hernia (CDH) are at high risk for feeding problems. Prevalence of G-tube placement and consequent nutritional outcomes of infants with CDH and G-tubes has not been described. Aims Determine factors associated with G-tube placement and growth in infants with congenital diaphragmatic hernia. Study design Retrospective cohort study of infants with CDH to evaluate the association of G-tube placement with risk factors using logistic regression. We also assessed the association between growth velocity and G-tube placement and other risk factors using linear regression. Subjects The subjects of the study were infants with CDH treated at Duke University Medical Center from1997 to 2013. Outcome measures Weight gain in infants with CDH that had G-tube placement compared to those infants with CDH that did not. Result Of the 123 infants with CDH, 85 (69%) survived and G-tubes were placed in 25/85 (29%) survivors. On adjusted analysis, extracorporeal membrane oxygenation (OR=11.26 [95% CI: 1.92–65.89]; P=0.01) and proton pump inhibitor use (OR=17.29 [3.98–75.14], P ≤0.001) were associated with G-tube placement. Infants without G-tubes had a growth velocity of 6.5 g/day (95% CI: 2.5–10.4) more than infants with G-tubes. Conclusion Survivors with more complex inpatient courses were more likely to receive G-tubes. Further investigation is needed to identify optimal feeding practices for infants with CDH.

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Percutaneous gastrostomy tubes in children with Pierre Robin sequence: efficacy, maintenance and complications

Abstract: G-tubes in PRS provide a safe method for nutrition until children feed adequately by mouth.

Cited by 10 publications

References 29 publications

Impact of Gastrostomy Tube Placement on Short‐Term Weight Gain in Hospitalized Premature Infants

Impact of Gastrostomy Tube Placement on Short‐Term Weight Gain in Hospitalized Premature Infants

A comparison of airway interventions and gastrostomy tube placement in infants with Robin sequence

Gastrostomy tube placement in infants with congenital diaphragmatic hernia: Frequency, predictors, and growth outcomes

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