A comparative longitudinal study of gastrostomy devices in children
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1University of British Columbia School of Nursing, Vancouver.
Insights
For children with cerebral palsy requiring long-term gastrostomy feeding, both skin-level and tube devices show similar outcomes. Selection should prioritize individual child and family needs over device type.
Area of Science:
- Pediatric Gastroenterology
- Neurology
- Caregiver Support
Background:
- Long-term gastrostomy is crucial for managing feeding/swallowing issues in children with severe spastic cerebral palsy.
- Existing research often overlooks long-term device implications for nurses and families.
Purpose of the Study:
- To compare the long-term efficacy of skin-level versus tube gastrostomy devices.
- To evaluate nutritional outcomes, complications, and caregiver satisfaction between device types.
Main Methods:
- Retrospective comparison of children with gastrostomy.
- Analysis of nutritional status, complication rates, and caregiver-reported satisfaction.
- Comparison between skin-level and tube gastrostomy devices.
Main Results:
- Few significant differences were observed between skin-level and tube gastrostomy devices.
- Nutritional outcomes, complication rates, and caregiver satisfaction showed no clear superiority of one device type.
- Findings contrast with manufacturer claims regarding skin-level device advantages.
Conclusions:
- Gastrostomy device choice should be individualized based on comprehensive child and family assessments.
- Current evidence does not support a universal preference for skin-level devices over tube devices.
- Long-term outcomes and caregiver perspectives are critical in device selection.
Abstract:
Long-term gastrostomy is a predictable intervention to ameliorate the effects of feeding and swallowing difficulties among children with severe spastic cerebral palsy. The evidence evaluating the efficacy and implications of the available gastrostomy devices in common use has focused primarily on the operative phase, ignoring the long-term effects that may be critical from a nurse's or family caregiver's point of view. In this study, the authors describe a sample of children with gastrostomy, comparing skin-level and tube devices on measures of nutritional outcome, complications, and caregiver satisfaction. In contrast to manufacturer's claims about the superiority of skin-level devices, the results presented here reveal few differences between the devices. The authors conclude, therefore, that device selection should be determined by individualized comprehensive assessment of the child and family circumstances.
