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A low-cost pediatric gastrostomy securement system for resource-limited settings: a preliminary observational study
Katherine Hu1, Josefina Sáez2,3, Loreto Ludueña4
1Stanford University School of Medicine, Stanford, CA, USA. khu10@stanford.edu.
Insights
A new low-cost device improves Foley catheter use for pediatric feeding in resource-limited settings. While functional and safe, future versions need enhanced durability and easier installation for better gastrostomy securement.
Area of Science:
- Biomedical Engineering
- Pediatric Gastroenterology
- Global Health
Background:
- Gastrostomy tubes (G-tubes) are costly, limiting access in resource-limited settings.
- Foley urinary catheters are used as affordable alternatives for pediatric feeding but lack securement.
- Inadequate securement of Foley catheters for feeding can lead to complications.
Purpose of the Study:
- To clinically validate a novel, low-cost securement device for Foley catheters.
- To improve the safety and functionality of Foley catheters as a pediatric gastrostomy securement system.
- To provide a viable feeding tube solution for low-resource environments.
Main Methods:
- A securement device for pediatric feeding tubes was developed and tested.
- The device was used in 11 pediatric patients (ages 1-15) for 8-14 days.
- Patient outcomes and user experiences were assessed via daily monitoring and surveys.
Main Results:
- The device demonstrated successful use in most patients, with 95% able to feed effectively.
- No major complications were reported; minor issues included leakage (36%) and dismantling (64%).
- User satisfaction, ease-of-use, and securement ratings significantly improved, with 82% willing to use it again.
Conclusions:
- The device shows promise as a functional, safe, and easy-to-use pediatric gastrostomy solution for low-resource settings.
- Improvements in durability and ease of installation are needed for future iterations.
- This innovation offers a potential pathway to enhance pediatric feeding care in underserved regions.
Purpose:
The high cost of gastrostomy tubes (G-tubes) limits their use and availability in resource-limited settings, where Foley urinary catheters are commonly used as low-cost alternatives for pediatric feeding. However, when used as feeding tubes, Foley catheters are prone to complications due to inadequate securement. This study aims to clinically validate a novel, low-cost securement device designed to improve the safety and functionality of Foley catheters as a pediatric gastrostomy securement system in low-resource settings.
Methods:
We developed a securement device for pediatric feeding tubes in resource-limited settings. The device was tested in 11 children (age 1-15 years) with Foley catheters at a long-term care hospital. Patients were monitored for 8-14 days during device use, with daily assessments for complications. Due to a design defect, the device was modified mid-study. Caregivers and medical staff completed pre- and post-study surveys about their experiences with previous securement methods and our device. The study was approved by the relevant ethics committees.
Results:
The device was successfully used in most patients. 95% of staff and caregivers were able to feed children effectively while using the device, and 85% could do so independently. Additionally, 82% indicated that they would use it again. No major complications occurred. However, minor issues were reported, including leakage in 4 (36%) patients and device dismantling in 7 (64%) patients. Staff and caregiver ratings of their child's pediatric gastrostomy securement system significantly increased after device use, particularly in terms of satisfaction, ease-of-use, and securement. Users liked the device's ability to secure the excess length of the catheter but suggested improvements in durability and ease of installation.
Conclusion:
The device shows potential as an effective pediatric gastrostomy solution for low-resource settings; it is functional, safe, and easy to use, but requires improvements in durability and ease of installation, which will be addressed in future advancements.
