Rapid Outpatient Tube Weaning Is Effective but Associated With Frequent Adverse Events: A Retrospective Cohort Study
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Josefine Limnell1,2, Mari Ahlroos3, Maisa Keski-Kuha1,4
1New Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Aim:
To evaluate the outcomes and safety of an outpatient tube-weaning programme involving rapid tube feed reduction.
Methods:
This retrospective patient record-based cohort study included children referred to a multidisciplinary, hunger provocation-based tube-weaning programme from 2016 to 2023 in our tertiary paediatric hospital. The primary outcome was complete tube weaning. Secondary outcomes were changes in oral feeding skills and adverse effects.
Results:
We traced 49 children with mostly somatic underlying diseases who had taken part in the programme. Of them, 65% achieved complete weaning and oral feeding improved in 92%, by programme completion. At a median follow-up of 2.4 years, 69% remained fully weaned. Patients with neurodevelopmental diseases benefited least. Adverse effects occurred in 49%, most commonly hypoglycaemia (37%) and dehydration (31%). Lower initial oral feeding skill was associated with reduced weaning success and a higher incidence of hypoglycaemic events. Children experiencing adverse effects-particularly hypoglycaemia-were less likely to be fully weaned.
Conclusions:
Rapid tube feed reduction within an outpatient hunger-provocation programme improved oral feeding but was associated with notable adverse effects. These findings support individualized tube feed reduction, patient monitoring and careful patient selection.
