Gastrostomies in children requiring long-term ventilation

Area of Science:

• Pediatric critical care
• Respiratory medicine
• Gastroenterology

Background:

• Children requiring long-term ventilation (LTV) via tracheostomy often need enteral tube feeding.
• Informing decisions about feeding support is crucial for these vulnerable patients.

Purpose of the Study:

• To determine the proportion of pediatric LTV patients who undergo gastrostomy insertion.
• To guide clinical decision-making regarding gastrostomy placement at the time of tracheostomy formation.

Main Methods:

• Retrospective review of pediatric patients on LTV via tracheostomy.
• Data collected over a 9-year period (2012-2020) at a single tertiary children's hospital.
• Analysis of gastrostomy insertion timing relative to tracheostomy.

Main Results:

• 73% of pediatric LTV patients with tracheostomy received gastrostomy feeding.
• Gastrostomy insertion occurred both before and after tracheostomy formation.
• Neither LTV indication nor prematurity predicted gastrostomy feeding status.

Conclusions:

• The majority of children requiring LTV are enterally tube-fed.
• Gastrostomy insertion should be proactively considered during tracheostomy formation for LTV patients.