Prolonged nasoenteral tube feeding in children contradicts best practice guidelines
CPS ePoster Library. Abobo M. Jun 22, 2016; 128196; 126
Moses Abobo
Moses Abobo
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Abstract
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Background: Expert consensus guidelines from the Canadian Pediatric Society and the American Academy of Pediatrics state that nasoenteral tube feeding is not appropriate for long term home nutrition support. Therefore, gastrostomy tubes are recommended for nutrition support predicted to last 2-3 months or more. A 2010 survey of pediatric health care providers at our institution demonstrated that 73% were unaware of these guidelines and 47% would consider a G tube only after 3-6 months.

Objectives: The objective of this study is to determine whether the duration of nasoenteral tube feeding in children at our centre is consistent with expert consensus guidelines.

Methods: Prospectivechart review of all patients younger than 17 years of age referred for home nutrition support from January 2014 - July 2015 was conducted, with data collection until the present.

Result: 310 children were referred for nutrition support. Excluding patients out of province, lost to follow-up or deceased within a year from referral, 237 children were included. 88% were initially fed with a nasoenteral tube; 76% of them were predicted to require tube feeding for months to years. 70% were fed with a nasoenteral tube for more than 3 months, with a mean duration of 4.8 months (range 0.07-20.3 months). 10% eventually underwent gastrostomy tube insertion, with a mean time to insertion of 9.7 months (0.07-20.3 months).

Conclusion: The duration of nasoenteral tube feeding in a significant proportion of children is longer than recommended by expert consensus guidelines. An important contributing factor is lack of knowledge amongst pediatric health care practitioners about existing best practice guidelines.
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