Tube feeding and bone marrow transplantation

Area of Science:

• Pediatric Hematology
• Gastroenterology
• Clinical Nutrition

Background:

• Children undergoing bone marrow transplantation (BMT) often experience poor oral intake due to intensive conditioning therapy.
• Nutritional support (NS) is crucial, with tube feeding (TF) generally preferred over parenteral nutrition (PN) due to its physiological benefits and lower complication rates.
• Despite preferences, children undergoing BMT are frequently managed with PN.

Purpose of the Study:

• To evaluate the tolerance and adequacy of tube feeding (TF) in pediatric patients undergoing bone marrow transplantation (BMT).
• To compare the efficacy, complications, and costs of TF versus parenteral nutrition (PN) in this patient population.

Main Methods:

• A comparative study involving two groups: TF (n=12) and PN (n=22).
• Nutritional status, intake, complications, and costs were assessed.
• Patients were transitioned to additional or total PN if TF intolerance occurred.

Main Results:

• Both TF and PN groups achieved adequate nutritional status, meeting 85% of requirements.
• TF was successfully implemented on 62% of NS days, with three children exclusively fed via TF.
• Extended pre-transplant TF duration correlated with improved enteral tolerance.
• Gastrointestinal symptoms were similar between groups, but cholestasis was less frequent with TF.
• The mean cost per child was $440 lower in the TF group compared to the PN group.

Conclusions:

• Tube feeding (TF) is a feasible and effective nutritional support method for children undergoing bone marrow transplantation (BMT).
• TF demonstrates comparable efficacy to parenteral nutrition (PN) in this population.
• TF offers significant potential cost savings, making it a budget-friendly option.