Complications of nasogastric and gastrostomy tube feedings in children with end stage renal disease.
Twelve children with end stage renal disease requiring dialysis received enteral feedings via nasogastric (NG) or gastrostomy (G) tube between 1984 and 1989 for provision of adequate nutrition. Records were reviewed for frequency and types of complications seen. Six patients, ages 1 week to 16 months received NG feedings for a total of 32 months. Complications included persistent vomiting with recurrent aspiration (2), persistent vomiting with peritoneal dialysis (PD) exit site leak (1), sinusitis (1), and refusal to continue NG feeds because of patient/parental anxiety (1). Three of the 6 were changed to G tube feedings after 2 days to 3 months. The complication rate was 1 per 6.4 patient months. Nine patients, ages 4 days to 11 years, received G tube feedings for 64 months. The complication rate was similar, 1 per 7.1 months. Complications were PD fluid leak around G tube exit site (1), G tube infection (2), G tube obstruction requiring tube replacement (3), tube migration producing intestinal obstruction (1), and gastrocutaneous fistula (2). Both methods were associated with similar complication rates, although somewhat different types of complications were seen. The young dialysis patient may have certain unique risks in addition to the complications generally associated with enteral feedings.
Wood
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Department of Pediatrics and Adolescent Medicine, St. Louis University, Cardinal Glennon Children's Hospital, MO.
Bunchman
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Khurana
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Fleming
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SS
Lynch
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RE
D002648:Child; D002675:Child, Preschool; D004750:Enteral Nutrition / Q000009:adverse effects*; D005774:Gastrostomy; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007441:Intubation, Gastrointestinal / Q000009:adverse effects; D007676:Kidney Failure, Chronic / Q000628:therapy*; D010530:Peritoneal Dialysis; D010531:Peritoneal Dialysis, Continuous Ambulatory; D011015:Pneumonia, Aspiration / Q000209:etiology; D013997:Time Factors; D014839:Vomiting / Q000209:etiology