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Gastrostomy in infants with neonatal pulmonary disease
D Guimber1, L Michaud, L Storme
1Departments of Pediatric Gastroenterology and Nutrition, Faculty of Medicine, University Hospital, Lille, France.
Insights
Gastrostomy feeding improves nutritional status in children with chronic lung disease and failure to thrive. While effective for caloric intake, oral aversive behaviors may worsen in some patients.
Area of Science:
- Pediatric Gastroenterology
- Neonatology
- Pediatric Pulmonology
Background:
- Children with severe chronic neonatal lung disease often experience failure to thrive and oral aversive behaviors.
- Malnutrition in these infants compromises growth and overall health outcomes.
Purpose of the Study:
- To evaluate the efficacy and outcomes of enteral nutrition via gastrostomy in pediatric patients with severe chronic neonatal lung disease.
- To assess the impact of gastrostomy feeding on nutritional status, pulmonary function, and oral behaviors.
Main Methods:
- A retrospective study of thirteen pediatric patients with chronic lung disease of neonatal onset and severe malnutrition.
- Enteral nutrition was administered via gastrostomy at a median age of 13 months.
Main Results:
- Significant improvement in weight-for-height Z-scores (from -3.4 to -1.9) and caloric intake (100% to 140% RDA) within four months.
- Stable pulmonary status and normal oxygenation were observed in all patients.
- Aggravation of oral aversive behavior occurred in 7 of 13 children, particularly those with prolonged ventilation and hospitalization.
Conclusions:
- Enteral nutrition via gastrostomy is an effective method for improving caloric intake and nutritional status in this patient population.
- Gastrostomy is a safe and convenient feeding technique that warrants early consideration for infants with malnutrition secondary to neonatal pulmonary disease.
Objective:
To report our experience of enteral feeding via gastrostomy in children with severe chronic neonatal lung disease, failure to thrive, and oral aversive behavior after initial hospitalization.
Population:
Thirteen patients were studied. All children had chronic lung disease of neonatal onset and were severely malnourished. They received enteral nutrition via a gastrostomy at a median age of 13 months (range: 8-35).
Results:
Z-scores for weight-for-height increased significantly, from -3.4 to -1.9 after four months of enteral nutrition. Caloric intake increased significantly from 100% to 140% of the recommended daily allowance for age. Pulmonary status remained stable for all patients and oxygenation was normal. There was an aggravation of oral aversive behavior in 7 of the 13 children, especially those children who were ventilated and hospitalized for a long time (median duration: 195 days). The median follow-up of patients after gastrostomy was 30 months (range: 8-54) and only six patients could be weaned from enteral nutrition.
Conclusion:
Enteral nutrition via gastrostomy is efficient, and provides the means to improve caloric intake and nutritional status. Gastrostomy is a safe and convenient technique that should be considered early in the course of treatment for infants presenting with malnutrition related to neonatal pulmonary disease.