Why wait: early enteral feeding after pediatric gastrostomy tube placement

Jensen, Amanda R.; Renaud, Elizabeth; Drucker, Natalie A.; Staszak, Jessica; Senay, Ayla; Umesh, Vaibhavi; Williams, Regan F.; Markel, Troy A.

doi:10.1016/j.jpedsurg.2017.06.015

Cited by 24 publications

(9 citation statements)

References 12 publications

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“…We used linked data to investigate gastrostomy use in children with ID in WA over a 32-year period where the prevalence was 277 cases per 10,000 live births (2.8%), compared with 6.7 cases per 10,000 live births in the general pediatric population [15]. The increasing prevalence of gastrostomy use may be influenced by its perceived value in reducing carer burden [6,33], enabling home-rather than hospital-based care [34,35], clinician preferences [36] and the importance of stabilizing nutritional support over the longer term. Increasing use may also reflect more proactive clinical management during the early years, in parallel with a remarkable period of social and political change that supports greater use of community-or home-based care for children with a disability [37][38][39] and enhanced accessibility and choice for individuals with disabilities[16, 38,40].…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of gastrostomy insertion for children and adolescents with intellectual disability

et al. 2018

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Prof Forbes conceptualized and designed the study, was responsible for obtaining funding, reviewed and revised the manuscript, and critically reviewed the manuscript for important intellectual content regarding aspects of gastroenterology. Dr Ravikumara conceptualized and designed the study, was responsible for obtaining funding, reviewed and revised the manuscript, and critically reviewed the manuscript for important intellectual content regarding aspects of gastroenterology. A/Prof Jacoby conceptualized and designed the study, was responsible for obtaining funding, provided specialist statistical support, and reviewed and revised the manuscript. Ms Bourke collected data for the study, and critically reviewed the manuscript for important intellectual content regarding aspects of intellectual disability. Dr Srasuebkul reviewed and critically reviewed the manuscript for important intellectual content regarding aspects of intellectual disability. Prof Trollor conceptualized and designed the study, was responsible for obtaining funding, reviewed and revised the manuscript, and critically reviewed the manuscript for important intellectual content regarding aspects of intellectual disability. Dr Wilson conceptualized and designed the study, was responsible for obtaining funding, reviewed and revised the manuscript, and critically reviewed the manuscript for important intellectual content regarding aspects of pediatric medicine. Prof Nagarajan conceptualized and designed the study, was responsible for obtaining funding, reviewed and revised the manuscript, and critically reviewed the manuscript for important intellectual content regarding aspects of pediatric medicine. A/Prof Jenny Downs conceptualized and designed the study, was responsible for obtaining funding coordinated and supervised linked data collection, reviewed and revised the manuscript and was the principal investigator of the research. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

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Section: Discussionmentioning

confidence: 99%

Epidemiology of gastrostomy insertion for children and adolescents with intellectual disability

et al. 2018

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“…As suggested by other authors, it is felt that patients can likely be started closer to goal feeds than is the current standard of care. 21,22 The mean (standard deviation) for the initial feeds as a percentage of goal was 20% (21%), whereas for the preprocedural feeds the mean (standard deviation) was 87% (39%). Because of the small size of the cohort for whom a higher percentage of goal feeds were started, there was a limitation in the ability to draw statistical conclusions.…”

Section: Discussionmentioning

confidence: 99%

Outcomes Associated With Early vs Late Initiation of Exclusive Enteral Feeding Regimens Following Laparoscopic Gastrostomy Tube Placement in the Pediatric Patient

et al. 2020

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Objectives Despite frequent placement of pediatric laparoscopic gastrostomy tubes (GTs), no rigorous evaluation of initial feeding and advancement regimens exists. Therefore, the aim of this study was to determine whether early enteral feeding after GT placement is associated with increased symptoms, procedural complications, or length of stay (LOS). Methods In this retrospective cohort study, the records of all patients at a tertiary care pediatric hospital who had gastrostomy placement were reviewed. Only patients fed exclusively via gastrostomy were included. Feeding was monitored starting with the first postoperative feed and subsequently in 24‐hour increments. Adverse events were recorded based on clinical documentation. Results A total of 480 patients met inclusion criteria. Patients who started feeds between 24 and 36 hours had a shorter LOS compared with those who started at 36–48 hours (P = .0072) or >48 hours (P < .0001). Patients requiring ≥60 hours to reach goal feeds had significantly longer LOS than the other groups. There was no difference in the distribution of the LOS based on percentage of goal feeds initiated. Patients who required ≥60 hours to attain goal feeds had the most feeding complications. Conclusions More aggressive feeding advancement and earlier initiation of feeds were associated with decreased LOS without an associated increase in adverse clinical events.

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“…In our study, there was a more significant correlation between the time of beginning postoperative feeding and the time of full feeding and the time of the first postoperative defecation, with the risk of feeding intolerance being greater for children whose first postoperative defecation occurred later. Furthermore, early feeding also promotes earlier recovery of gastrointestinal function, and faster attainment of full feeding means shorter time to hospital discharge [ 12 – 14 ]. The time to reach full feeding was 23.05 and 39.93 days for the successful and unsuccessful feeding group, respectively; this difference needs to be considered in the context of the effect of the time of the first defecation, the frequency and the amount of defecation on the feeding intolerance, and the discrepancy of 16 days between the two groups is more indicative of the effect of the feeding intolerance on the time to reach full feeding.…”

Section: Discussionmentioning

confidence: 99%

Correlation analysis of feeding intolerance and defecation after primary anastomosis for neonatal intestinal atresia

Zhou,

Chen,

Wang

et al. 2023

Pediatr Surg Int

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Purpose To investigate the correlation between postoperative feeding intolerance and defecation, with a view to carrying out prognostic assessment and timely intervention for the recovery of postoperative gastrointestinal function. Methods The 114 neonates with congenital intestinal atresia who underwent primary anastomosis admitted to Shenzhen Children's Hospital from January 2014 to December 2022 were studied, and the patients' basic information, intraoperative conditions, postoperative feeding and defecation, and hospitalization time were retrospectively analyzed. Results The risk factors for feeding intolerance after primary anastomosis for intestinal atresia are the gestational days, the time of the first postoperative defecations, the number of defecations on the previous day and the average number of defecations before feeding. Conclusion The incidence of postoperative feeding intolerance is higher in preterm infants, and pediatricians can decide the timing of breastfeeding on the basis of the patients’ defecation. The focus on accurate defecation may be more meaningful in determining and predicting postoperative feeding intolerance in the infants.

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Why wait: early enteral feeding after pediatric gastrostomy tube placement

Abstract: III.

Cited by 24 publications

References 12 publications

Epidemiology of gastrostomy insertion for children and adolescents with intellectual disability

Epidemiology of gastrostomy insertion for children and adolescents with intellectual disability

Outcomes Associated With Early vs Late Initiation of Exclusive Enteral Feeding Regimens Following Laparoscopic Gastrostomy Tube Placement in the Pediatric Patient

Correlation analysis of feeding intolerance and defecation after primary anastomosis for neonatal intestinal atresia

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