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Nasogastric tube feedings in children with high-risk cancer: a pilot study
J B Pietsch1, C Ford, J A Whitlock
1Department of Pediatric Surgery, Vanderbilt University Medical Center, Nashville, Tenessee, USA.
Insights
Nasogastric tube feedings are feasible for children undergoing chemotherapy or bone marrow transplant, offering a safe and cost-effective alternative to total parenteral nutrition.
Area of Science:
- Pediatric Oncology
- Gastroenterology
- Nutrition Support
Background:
- Total parenteral nutrition (TPN) is associated with significant costs and complications.
- Alternative nutritional support methods are needed for pediatric patients undergoing intensive treatments.
Purpose of the Study:
- To evaluate the feasibility of nasogastric (NG) tube feedings in children receiving chemotherapy (CTX) or bone marrow transplantation (BMT).
- To compare the cost-effectiveness of NG tube feedings versus TPN.
Main Methods:
- Seventeen pediatric patients (2-19 years) received continuous NG tube feedings with a glutamine-supplemented elemental diet during CTX or BMT.
- Feedings were administered during treatment and for fever, neutropenia, and mucositis.
Main Results:
- NG tube feedings were well-tolerated with no sinusitis or epistaxis.
- Total cost for enteral feedings was $25,348, compared to $112,299 for TPN over the same duration.
- Six patients required supplemental TPN.
Conclusions:
- Nasogastric tube insertion and enteral feedings are safe and feasible in pediatric patients undergoing intensive CTX or BMT.
- Enteral tube feedings offer significant cost savings compared to TPN in this population.
Purpose:
To avoid the cost and complications of total parenteral nutrition (TPN), this study was initiated to determine the feasibility of administrating nasogastric tube feedings in children receiving intensive chemotherapy (CTX) or bone marrow transplantation (BMT).
Patients And Methods:
Seventeen children (aged 2 to 19 years) were entered into the study. Continuous nasogastric feedings of a glutamine-supplemented elemental diet were administered during CTX and at the time of rehospitalization for fever, neutropenia, and mucositis.
Results:
Fourteen children were treated with CTX and 3 with BMT. Enteral tube feedings were administered for 216 days; each patient received a mean of 12.7 days. The tubes were generally well tolerated, and there were no instances of sinusitis or epistaxis. Six children received TPN in addition to enteral feedings. The hospital charges for the enteral feedings were $25,348, compared to $112,299 for the same number of days of TPN.
Conclusions:
Nasogastric tube insertion and enteral tube feedings in children receiving intensive CTX or BMT can be accomplished with minimal complications and significant cost savings when compared to TPN.