Button Gastrostomy Tubes for Pediatric Patients: A Tertiary Care Center Experience

Background and Objective. Gastrostomy tube insertion is one of the most common procedures performed as a radical choice to overcome feeding difficulty in children. This study is aimed at describing the replacement of a button tube instead of the long tube for feeding infants and children requiring gastrostomies in a tertiary care hospital. Design and Setting. This retrospective cross-sectional descriptive study was conducted between January 2009 and August 2019 at Salmaniya Medical Complex which is a tertiary health care institute in the Kingdom of Bahrain. Subjects and Methods. Both charts and electronic health records of pediatric patients between the ages of 0 and 14 years were reviewed. Data were collected including age, sex, nationality, diagnosis, surgical information (procedure center and procedure performed), complications, and follow-up. Results. Out of 34 patients who underwent gastrostomy tube insertion, 30 patients had their long tube replaced by a button gastrostomy. Majority were males (N=18, 60%). Prolonged nasogastric tube feeding was the main indication of referral (N=17, 56%) followed by feed intolerance (N=6, 17%) and gastroesophageal reflux disease (N=5, 16%). The main underlying diseases at referral were neurological impairment (N=19, 63%) and metabolic disorders (N=4, 13%). There was no significant difference between patients with neurological disorders and other diseases in terms of gender, nationality, or age. Laparotomy with gastrostomy is the main approach used (N=18, 60%). No reported complications of button tubes in 50% of the patients (N=15). Conclusions. Prolonged nasogastric tube feeding is the main indication of referral for gastrostomy tube insertion. Neurological disorders are the main diagnosis for the cases operated upon. Laparotomy with gastrostomy is the procedure of choice at our center. Majority of patients had no reported complications of button tube replacement. These children are likely to benefit from the button tube with fewer complications.

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Nasogastric Tube Feeding Practice and Associated Complication in stroke Patients in a Tertiary Care Hospital in Bangladesh

Journal of National Institute of Neurosciences Bangladesh ◽

10.3329/jninb.v4i1.38281 ◽

2018 ◽

Vol 4 (1) ◽

pp. 23-27 ◽

Cited By ~ 1

Author(s):

Kazi Mohibur Rahman ◽

Sharif Uddin Khan ◽

ATM Hasibul Hasan ◽

Sirajee Shafiqul Islam ◽

Rajib Nayan Chowdhury ◽

...

Keyword(s):

Aspiration Pneumonia ◽

Nasogastric Tube ◽

Tertiary Care ◽

Tube Feeding ◽

Electrolyte Imbalance ◽

Feeding Practice ◽

Care Hospital ◽

Stroke Patients ◽

Nasal Irritation ◽

Nasogastric Tube Feeding

Background: Nasogastric tube feeding is an integral part of management of stroke patients with feeding difficulties.Objectives: The purpose of the present study was to evaluate the nasogastric tube feeding practice and its complication on stroke patients.Methodology: One hundred (100) adult patients aged ≥ 18 years with stroke were enrolled in the study. The diagnosis of stroke was established by the clinical presentation, neuroimaging. Patients requiring nasogastric tube feeding was included in the study. They were thoroughly examined for any complications from possible use of nasogastric tube. Their caregivers were also thoroughly interviewed using a standard preformed questionnaire regarding any complications as well. Results: A total number of 100 patients were recruited for this study. In this study population, 63.0% patients had ischaemic stroke; 26.0% had haemorrhagic stroke and 9.0% population had sub-arachnoid haemorrhage. The most common indication for NG feeding was difficulty in swallowing (39.0%) followed by semi consciousness (26.0%), unconsciousness (22.0%), inability to maintain feed (10.0%). About 71.0% of the patients had complications from NG tube feeding such as nasal irritation (53.0%), electrolyte imbalance (43.0%), aspiration pneumonia (40.0%) and diarrhea (38.0%).Conclusion: Nasal irritation, aspiration pneumonia, electrolyte imbalance, diarrhea are common complications associated with NG tube feeding which in part may be related to faulty feeding technique.Journal of National Institute of Neurosciences Bangladesh, 2018;4(1): 23-27

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Nasogastric tube feeding and percutaneous endoscopic gastrostomy tube feeding in patients with head and neck cancer

Journal of Human Nutrition and Dietetics ◽

10.1111/j.1365-277x.2010.01047.x ◽

2010 ◽

Vol 23 (3) ◽

pp. 277-284 ◽

Cited By ~ 35

Author(s):

B. Nugent ◽

M. J. Parker ◽

I. A. McIntyre

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Percutaneous Endoscopic Gastrostomy ◽

Neck Cancer ◽

Nasogastric Tube ◽

Tube Feeding ◽

Gastrostomy Tube ◽

Percutaneous Endoscopic Gastrostomy Tube ◽

Endoscopic Gastrostomy ◽

Nasogastric Tube Feeding

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Gastrostomy Tube Supplementation for HIV-infected Children

PEDIATRICS ◽

10.1542/peds.96.4.696 ◽

1995 ◽

Vol 96 (4) ◽

pp. 696-702

Author(s):

Tracie L. Miller ◽

Ester L. Awnetwant ◽

Sylvia Evans ◽

Vivien M. Morris ◽

Isabel M. Vazquez ◽

...

Keyword(s):

Nasogastric Tube ◽

Caloric Intake ◽

Tube Feeding ◽

Gastrostomy Tube ◽

Z Score ◽

Cd4 Counts ◽

Lower Weight ◽

Z Scores ◽

Hospital Days ◽

Nasogastric Tube Feeding

Objective. Malnutrition is common in pediatric human immunodeficiency virus (HIV) infection, and little is known of effective nutritional interventions. We sought to determine whether enteral supplementation with gastrostomy tube feedings would provide improvements in weight, height, body composition, immune parameters, morbidity, and mortality. Methods. We collected clinical data on 23 HIV-in-fected children who were fed chronically by gastrostomy tube. The main outcome measures included weight, height, triceps skinfold thickness (TSF), arm-muscle circumference (AMC), hospital days, caloric intake, and CD4-positive T-lymphocyte count. Each of these parameters was measured or evaluated at four points: 6 months before nasogastric tube feeding, at the time nasogastric tube feeding was initiated, at the time gastrostomy tube feeding was initiated, and 6 months after gastrostomy tube feedings began. Results. Weight z score [-2.1 (0.14) to -1.58 (0.14)] and weight-for-height z score [-0.98 (0.16) to -0.15 (0.17)] improved with gastrostomy tube feedings. There was a trend toward improvement in weight z score with nasogastric tube feedings. Caloric intakes increased progressively with nasogastric and gastrostomy tube feedings. No improvement in height, TSF, AMC, hospital days, or CD4 counts was seen in the follow-up period. However, children who had the greatest increase in weight had the most improvement in fat stores (TSF) (r = .65, P = .002) and a decrease in hospital days after the gastrostomy tube was placed (r = -.48, P = .025). Higher age-adjusted CD4 counts and lower weight-for-height z scores at the time of enteral supplementation were significant predictors of a positive response to gastrostomy tube feedings(r = .85, P = .0001). Children who responded favorably had a 2.8-fold reduction in the risk of dying for every positive unit change in weight z score (P = .005). Conclusion. Gastrostomy tube supplementation for HIV-infected children can improve weight and fat mass when other oral methods fail. Weight gain is coincident with greater caloric intakes. HIV-infected children with higher CD4 counts and lower weight-for-height z scores are likely to respond favorably to gastrostomy tube feedings. Early nutritional intervention is indicated for HIV-infected children.

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Nasogastric Tube Feeding in Infants on Peritoneal Dialysis

Peritoneal Dialysis International ◽

10.1177/089686089601601s107 ◽

1996 ◽

Vol 16 (1_suppl) ◽

pp. 521-527 ◽

Cited By ~ 25

Author(s):

Bradley A. Warady ◽

Lynette Weis ◽

Leslie Johnson

Keyword(s):

Peritoneal Dialysis ◽

Nasogastric Tube ◽

Dialysis Patient ◽

Nutritional Support ◽

Tube Feeding ◽

Gastrostomy Tube ◽

Regular Component ◽

Nonoral Feeding ◽

Nasogastric Tube Feeding

Enteral nutritional support is an important component of the care provided to infants receiving long-term peritoneal dialysis. In the majority of published experiences on this subject, the use of the nasogastric tube has facilitated the provision of required calorie and protein intake and resulted in an improved patient outcome. Advantages of the nasogastric route of nutritional support include the ease of administration, while recurrent emesis remains the most troublesome and frequent shortterm complication associated with its use. Impaired oralmotor development may also result from nonoral feeding and should be addressed throughout the course of tube feeding. The outcome of infants with ESRD receiving CPD has markedly improved since the introduction of NG feedings as a regular component of dialysis patient care. While complications associated with NG feedings have been documented, the benefits associated with this route of nutritional supplementation have been great. Currently, an increasing number of infants/ young children on CPD are receiving supplemental nutrition with the use of the gastrostomy tube/button (31). However, the risks associated with this route of therapy in the CPD population, especially in terms of infection, are as yet not well defined (32). Once the risk/benefit ratio of gastrostomy tube/button placement is determined, future efforts should be directed towards better defining how the two routes of enteral nutritional support (e.g., NG tube, gastrostomy tube/button) may best complement one another.

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