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Percutaneous endoscopic gastrostomy tubes in pediatric bone marrow transplant patients

Sunpreet Kaur1, Clare Ceballos, Ruijun Bao

  • 1Division of Pediatric Gastroenterology and Nutrition, Mount Sinai School of Medicine, New York, NY 10029, USA.

Journal of Pediatric Gastroenterology and Nutrition
|October 23, 2012
PubMed

Insights

Percutaneous endoscopic gastrostomy (PEG) placement poses a higher infection risk for bone marrow transplant (BMT) patients, especially those with neutropenia. Consider alternative nutrition support for BMT recipients.

Area of Science:

  • Pediatric Gastroenterology
  • Hematology/Oncology
  • Surgical Critical Care

Background:

  • Optimal nutrition delivery for pediatric bone marrow transplant (BMT) patients remains undefined.
  • Gastrostomy tubes are a common nutritional support method, but complication risks in BMT patients require investigation.

Purpose of the Study:

  • To determine the incidence and risk factors for gastrostomy tube complications in pediatric BMT patients.
  • To compare complication rates between BMT patients and a control group receiving gastrostomy tubes for other indications.

Main Methods:

  • Retrospective chart review of pediatric patients undergoing percutaneous endoscopic gastrostomy (PEG) placement over a 3-year period.
  • Analysis included BMT patients and a comparison group, examining complication occurrences and absolute neutrophil count (ANC) at PEG placement and complication.
  • Demographic and clinical data were compared between groups.

Main Results:

  • The BMT group experienced a significantly higher incidence of major PEG complications (36%) compared to the control group (2.8%) (P=0.01).
  • Infections were the primary complication in BMT patients, with 3 requiring PEG removal.
  • Neutropenia at the time of PEG placement and complication was noted in BMT patients with major complications.

Conclusions:

  • Absolute neutrophil count (ANC) is a critical factor to consider before PEG placement in BMT patients.
  • Significant neutropenia may serve as a contraindication for PEG use in this population.
  • Alternative nutrition support modalities should be explored for BMT patients to mitigate PEG-related risks.
Abstract

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