Tube feeding and bone marrow transplantation.
BACKGROUND
Children undergoing bone marrow transplantation (BMT) have poor oral intake during the transplant period, caused mainly by the intensive therapy used for their conditioning. Nutritional support (NS) is almost always needed. Whenever possible, tube feeding (TF) is preferred to parenteral nutrition (PN) because its more physiologic and causes fewer complications. However, children undergoing BMT are usually parenterally fed. We, therefore, studied whether TF was tolerated in children undergoing BMT and whether the nutritional intake was adequate in comparison to PN.


METHODS
Two groups were compared: TF (n = 12) and PN (n = 22). If intolerance for TF occurred, additional or total PN was given. Nutritional status, intake, complications, and costs were assessed.


RESULTS
Both groups had an adequate nutritional status and reached 85% of their nutritional requirements. TF was possible in 62% of the NS days and three children could be exclusively fed with TF. A longer pre-transplant duration of TF seemed to increase the enteral tolerance. Gastrointestinal symptoms were equally frequent in TF as in PN, but cholestasis was less frequent in TF. The mean nutritional cost per child in the TF group was 440 US dollars less than in the PN group.


CONCLUSIONS
TF is possible and equal in efficacy to PN in children undergoing BMT, and may have budgetary benefits.
Hopman
G D
GD
Department of Dietietics and Nutrition, Leiden University Medical Center, Leiden, The Netherlands.
Peña
E G
EG
Le Cessie
S
S
Van Weel
M H
MH
Vossen
J M J J
JM
Mearin
M L
ML
D000293:Adolescent; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D004750:Enteral Nutrition / Q000009:adverse effects / Q000191:economics / Q000379:methods; D005260:Female; D005767:Gastrointestinal Diseases / Q000209:etiology; D017048:Health Care Costs; D006801:Humans; D008297:Male; D009752:Nutritional Status; D010288:Parenteral Nutrition