Abstract
The aim of the study was to assess the anthropometric outcomes after gastrostomy tube (GT) placement in children with chronic diseases and the influence of primary diagnosis, age, and nutritional support. A longitudinal, multicenter, and prospective study was performed evaluating 65 children with GT feeding and chronic diseases (61.5% with neurological disease). Each child was evaluated three times (at baseline and at 6 and 12 months after GT placement) and the following data was collected: primary diagnosis, age at GT placement, anthropometry, and feeding regime. Repeated measures ANOVA were used to analyze the main effects (intra and intergroup) and the interactions effects on weight gain and linear growth at 6 and 12 months after GT placement. All patients significantly improved their body mass index (BMI)-for-age z-score (p < 0.001) and height-for-age z-score (p < 0.05) after 6 and 12-month of follow-up. BMI gain increased significantly the first 6 months, followed by a plateau, while height followed a linear trend. Children with GT placement before 18 months old experienced an accelerated growth rate during the first 6 months post-GT. This technique showed the effectiveness of GT placement improving nutritional status and growth catch up regardless of their primary diagnosis and the type of nutritional support.
Highlights
Pediatric patients with chronic diseases often suffer growth delay and restriction on their nutritional status linked to feeding issues, high nutritional requirements, and/or an inadequate caloric intake, which means they need specific nutritional support to prevent undernutrition and growth failure [1,2,3,4,5].Home enteral nutrition (HEN), by gastrostomy tube (GT), has been proved to be a secure technique for these patients that improves or reverts an undernourishment state and simplifies their care, reduces hospitalization length, and decreases respiratory and infectious complications [1,6,7,8]
Placement before 18 months old experienced an accelerated growth rate during the first 6 months post-GT. This technique showed the effectiveness of GT placement improving nutritional status and growth catch up regardless of their primary diagnosis and the type of nutritional support
These study results evidence that HEN using a GT is an efficacious treatment that improves the nutritional status of children suffering from chronic diseases
Summary
Pediatric patients with chronic diseases often suffer growth delay and restriction on their nutritional status linked to feeding issues, high nutritional requirements, and/or an inadequate caloric intake, which means they need specific nutritional support to prevent undernutrition and growth failure [1,2,3,4,5].Home enteral nutrition (HEN), by gastrostomy tube (GT), has been proved to be a secure technique for these patients that improves or reverts an undernourishment state and simplifies their care, reduces hospitalization length, and decreases respiratory and infectious complications (i.e., aspirative pneumonia due to severe disphagia and subsequent infection) [1,6,7,8]. In these patients, GT feeding, especially in highly dependent children, contribute to better outcome of the main disease and prolong their survival rate, with this being the case for children suffering from severe neurological disability [11,12,13]. GT feeding, especially in highly dependent children, contribute to better outcome of the main disease and prolong their survival rate, with this being the case for children suffering from severe neurological disability [11,12,13] This nutritional support may favor the patients’ global improvement, increasing their own and their carers’ quality of life [10,14,15]. They perceived an improvement in their child’s nutritional status higher than that quantified by the anthropometric assessment [18]
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