Retrospective Analysis Of A One-year Outcome Of Gastrostomy Tubes In Children: A Clinical Report In A Developing Country

Background: Current data show a variety of negative aspects related to persistent use of a gastrostomy tube in developed countries: lack of scientific proof to indicate gastrostomy tubes (GT) over nasogastric tubes (NGT), GTs should only be considered on individuals unable to thrive, potential GT risks may outweigh its benefits, and caregivers’ opinions must be taken into consideration. Objective: To analyze the impact of chronic use of gastrostomy tubes in pediatric patients one year after its placement, through the assessment of anthropometric variables in a hospital of a developing country. Methods: This study had a cohort-type intervention. Biosocial and anthropometric parameters were assessed and compared through Paired T-Tests, before and after one year of gastrostomy tube feeding. Findings: 24 patients were assessed one year after gastrostomy tube (GT) placement. It was globally observed that, in all ages assessed, all anthropometric variables (weight, length and body mass index) improved. On average this sample gained 3.89 kilos (p<0.000), 8.87 cm. (p<0.000) and 1.72 kg/mt2 (p<0.001). Also, this cohort showed an undernourishment rate of 25% prior to GT placement, and it reduced to 4.1% after one year of enteral nutrition use. Likewise, normal nutritional status improved from 41.6% to 91.6% in this CP sample. Long-term parameters for nutritional assessment (length/age) were also improved, reducing short/age parameters by 8.33% (p<0.002). No overweight or obese children were found. Interpretation: This study has confirmed that enteral nutrition is vital to improve nutritional status of pediatric patients in long-term parameters. Gastrostomy tubes have been proven to reduce morbidity, mortality, and hospitalizations, as well as secure survival and improve quality of life in people with CP. Due to high prevalence of disabled people in developing countries, rehabilitation (including dysphagia management) is indispensable to recover and retrieve oral feeding, in order to reduce the costs of maintenance of enteral nutrition for families and the health system. Developing countries, like Chile, lack access to rehabilitation leading to chronic usage of gastrostomy tubes. Clinicians see themselves forced to secure survival with GTs, despite potential risks showed in developed countries.