title: External leakage from feeding gastrostomies in patients receiving valproate sprinkle.
abstract: We reviewed the incidence of external leakage from feeding gastrostomies in 8 patients who received valproate sprinkle (VPA-S). We also identified a control group of 31 children with feeding gastrostomies who were also cared for in our clinic, but who did not receive VPA-S. All patients in both groups have had their feeding gastrostomy greater than or equal to 6 months. Four of 8 children who received VPA-S through feeding gastrostomies developed problems with recurrent external leakage. The incidence of external leakage in our control group of children who had not received VPA-S was 2 in 31 (6.4%). We hypothesize that the external leakage is caused by adherence of the undissolved VPA-S particles to the exterior of the tube, preventing close approximation of the tube to the gastrostomy stoma. In most cases, VPA-S could continue to be administered and the problem of leakage reduced if the tubes were more frequently changed and/or a larger size were used. Complications with either leakage or occlusion were noted in all patients with the button feeding tube who had received VPA-S. Because of the especially high complication rate associated with administration of VPA-S in children with the "button" feeding tubes, we discourage VPA-S administration to children with that device.
authors.affiliation: Gillette Children's Hospital, Minneapolis, Minnesota.
authors.forename: C
authors.initials: C
authors.lastname: Jones-Saete
authors.forename: R L
authors.initials: RL
authors.lastname: Kriel
authors.forename: J C
authors.initials: JC
authors.lastname: Cloyd
mesh_terms: D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D004333:Drug Administration Routes; D004359:Drug Therapy, Combination; D004750:Enteral Nutrition / Q000295:instrumentation; D004827:Epilepsy / Q000188:drug therapy* / Q000628:therapy; D004868:Equipment Failure; D005526:Food, Formulated; D005774:Gastrostomy / Q000295:instrumentation; D006801:Humans; D014677:Pharmaceutical Vehicles; D012996:Solutions; D014635:Valproic Acid / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D014677:Pharmaceutical Vehicles; D012996:Solutions; D014635:Valproic Acid