Comparison of Tolerance and Complication Rates Between Early and Delayed Feeding After Percutaneous Endoscopic Gastrostomy Placement in Children.
J Pediatr Gastroenterol Nutr
; 70(1): 55-58, 2020 01.
Article
in En
| MEDLINE
| ID: mdl-31567888
ABSTRACT
BACKGROUND:
Enteral nutrition is commonly initiated 24 hours after percutaneous endoscopic gastrostomy (PEG) in children. Adult studies report safe refeeding within 1 to 6âhours of PEG, and these findings have been cautiously applied to children. Comparative studies assessing early versus next-day refeeding in children are currently lacking. This study evaluates feeding tolerance and complications following early versus next-day refeeding in children.METHODS:
This is a single-center, pre-post study. In June 2015 our clinical practice changed to begin refeeding within 6 hours of PEG. Children receiving early refeeding from December 2015 to August 2017 were included. A retrospective cohort from February 2013 to April 2015 was used for comparison.RESULTS:
Forty-six children received early refeeding after PEG and 37 received next-day refeeding. Gender distribution was similar in the 2 groups. Early refeeding patients were slightly older (3.5 vs 2.2 years) and heavier (15.5 vs 11.5âkg) at PEG placement compared to next-day refeeding patients. Early refeeding patients experienced greater postprocedural nausea and/or vomiting (19% vs 8%, Pâ<â0.001) and leakage, irritation, and infection around the stoma (19% vs 0.0%, Pâ<â0.001). Compared to early refeeders, next-day refeeding patients experienced higher occurrence of fever (35% vs 13%, Pâ=â0.021), longer nutritional disruption (24.6 vs 3.7âhours, Pâ<â0.001), and longer length of stay (51 vs 27âhours; Pâ<â0.001). One next-day refeeding patient experienced peritonitis. One early refeeding patient experienced cellulitis requiring hospitalization and a second experienced gastrostomy tube migration into the peritoneal cavity requiring removal.CONCLUSION:
Early refeeders experienced higher rates of postprocedural nausea or vomiting and irritation, leakage, or infection around the stoma; but experienced lower rates of postoperative fever. Early refeeding resulted in reduced nutritional interruption and hospital length of stay.
Full text:
1
Database:
MEDLINE
Main subject:
Time Factors
/
Gastrostomy
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Enteral Nutrition
/
Postoperative Nausea and Vomiting
Type of study:
Etiology_studies
/
Observational_studies
Limits:
Adolescent
/
Child
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Child, preschool
/
Female
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Humans
/
Infant
/
Male
Language:
En
Year:
2020
Type:
Article