Intensive multidisciplinary intervention while on nasogastric tube feeding prevents the need for gastrostomy tube...

Intensive multidisciplinary intervention (IMI) can reduce dependence on gastrostomy tube (G-tube) feeding in children with pediatric feeding disorder. However, there are no data on using IMI to prevent G-tube placement in children with nasogastric tubes (NGTs). This study describes outcomes of patients with an NGT in place admitted to IMI with the goal of prevention of G-tube placement. Retrospective data from 2017 to 2022 including demographics, anthropometric data, and energy intake were assessed for children with NGT completing an 8-week IMI (at intake, discharge, and 1-year follow-up). Success was defined as taking 100% energy orally and improving nutrition status or maintaining weight-for-length/body mass index z-score > -2. Thirty patients (11 females) with mean age of 21.8 months (SD: 15.4) and with NGT in place for a mean of 7.1 months (SD: 4.7) and mean oral energy consumption of 18.1% (SD: 20.9) were included. At 1-year follow-up, 23 patients (76%) successfully had their NGT removed and maintained nutrition status. Successful children were likely to be older (average: 24.2 vs 14 months; P = 0.03) and consuming a greater proportion of energy orally at discharge (mean: 88.6% vs 42.0%; P = 0.001). No differences were seen between the groups in anthropometric measurements, length of NGT placement, or percentage of energy consumed orally at admission. IMI is a potentially useful tool to help increase oral intake and prevent the need for G-tube placement. Future research is needed to demonstrate who benefits the most from this type of approach and to understand the ideal treatment methodology to optimize outcomes.