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Gastrostomy tube placement in infants with congenital diaphragmatic hernia: Frequency, predictors, and growth

Sharmistha Rudra1, Obinna O Adibe2, William F Malcolm3

  • 1Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, United States.

Early Human Development
|August 26, 2016
PubMed

Insights

Gastrostomy tubes (G-tubes) are common for infants with congenital diaphragmatic hernia (CDH) facing feeding issues. Survivors with complex hospital stays, ECMO, or PPI use were more likely to receive G-tubes, impacting growth velocity.

Area of Science:

  • Pediatric Surgery
  • Neonatology
  • Gastroenterology

Background:

  • Infants with congenital diaphragmatic hernia (CDH) frequently experience feeding difficulties.
  • Gastrostomy tube (G-tube) placement is a common intervention for severe feeding issues in newborns.
  • Limited data exists on G-tube prevalence and nutritional outcomes in CDH infants.

Purpose of the Study:

  • To identify factors associated with G-tube placement in infants with CDH.
  • To evaluate the impact of G-tube placement on growth velocity in CDH infants.

Main Methods:

  • Retrospective cohort study of CDH infants (1997-2013) at Duke University Medical Center.
  • Logistic regression analyzed risk factors for G-tube placement.
  • Linear regression assessed associations between growth velocity, G-tube placement, and other risk factors.

Main Results:

  • Of 123 CDH infants, 85 survived, with 29% receiving G-tubes.
  • Extracorporeal membrane oxygenation (ECMO) and proton pump inhibitor (PPI) use were significantly associated with G-tube placement.
  • Infants without G-tubes exhibited a growth velocity 6.5g/day greater than those with G-tubes.

Conclusions:

  • CDH survivors with more complex inpatient courses were more likely to receive G-tubes.
  • G-tube placement was associated with reduced growth velocity in CDH infants.
  • Further research is needed to optimize feeding strategies for CDH patients.
Abstract

Keywords:
FeedingG-tubeNeonate

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