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Enteral nutritional support by percutaneous endoscopic gastrostomy in children with congenital heart disease
1Abteilung für Kardiologie, Klinik mit Poliklinik für Kinder und Jugendliche der Universität Erlangen-Nürnberg, Loschgestrasse 15, D-91054 Erlangen, Germany.
Insights
Percutaneous endoscopic gastrostomy (PEG) offers a safe and effective method for nutritional support in children with severe congenital heart disease (CHD). This technique improves nutritional status and weight gain, with good parental acceptance and few complications.
Area of Science:
- Pediatrics
- Gastroenterology
- Cardiology
Background:
- Children with severe congenital heart disease (CHD) often suffer from poor nutritional status, impacting surgical outcomes.
- Long-term nasogastric tube feeding presents disadvantages for nutritional support in these patients.
Purpose of the Study:
- To evaluate the safety and efficacy of percutaneous endoscopic gastrostomy (PEG) for enteral nutritional support in pediatric patients with severe CHD.
Main Methods:
- Retrospective analysis of 15 children with severe CHD who underwent PEG insertion.
- Assessment of complications during PEG insertion and feeding.
- Monitoring of nutritional status and weight gain in patients followed for at least 6 months.
Main Results:
- No major complications occurred during PEG insertion or feeding.
- Minor complications were infrequent.
- Significant weight gain ( >1 SD or >0.5 SD) was observed in 6 out of 8 children followed for 6 months.
- Enteral support via PEG was discontinued in 7 children after 2.5 to 42 months.
- Parental acceptance of PEG was favorable despite initial concerns.
Conclusions:
- Percutaneous endoscopic gastrostomy (PEG) is a safe and reliable method for providing enteral nutrition in children with severe congenital heart disease (CHD).
- PEG facilitates improved nutritional status and weight gain, enhancing the overall management of these complex pediatric patients.
Abstract:
One of the major problems of children with severe congenital heart disease (CHD) is their poor nutritional status. Among other consequences, it influences the surgical outcome. Retrospectively we present our experience with percutaneous endoscopic gastrostomy (PEG) in 15 children with CHD. This technique allows enteral nutritional support without the disadvantages related to long-term nasogastric tube feeding. Major complications were absent, and minor complications were rare both at PEG insertion, which was performed under deep sedation, and during feeding via PEG tube. In 4 of the 8 children who were followed for at least 6 months the age-matched body weight increased more than one standard deviation. In 2 other patients it increased more than 0.5 standard deviations. In 7 children the tube was removed after 2.5 to 42 months since enteral support was no longer necessary. Apart from initial reservations the parental acceptance of PEG was good. We conclude that the PEG is a safe and reliable technique to support enteral nutrition in children with severe CHD.