Comparing Feeding Methods in Pediatric Bone Marrow Transplants: Mixed Methods Study

October, 10, 2023 | Gastric Cancer, Gastrointestinal Cancer

KEY TAKEAWAYS

  • This trial aimed to examine the complications and outcomes of nasogastric and gastrostomy tubes in pediatric BMT, focusing on parental choices and the children’s feeding experiences.
  • The study found that nasogastric and gastrostomy tubes had similar nutritional outcomes and complication rates for children post-BMT.

The study gathered quantitative data on complications and nutrition from electronic records and food diaries. The data compared children having allogeneic bone marrow transplant (BMT) who were fed via gastrostomy or nasogastric tube from their admission up to six months post-BMT. For the qualitative portion, parents and children underwent two semi-structured interviews, one during admission and the other 1-2 months after discharge. Interview content was recorded, transcribed, and analyzed thematically. Child-specific data isn’t presented in this summary.

The study comprised 19 children in the nasogastric group and 24 in the gastrostomy group (88% recruitment rate). During the fourth and sixth weeks, nasogastric tube users experienced more complications than those with gastrostomies (47.4% vs. 8.3% and 47.1% vs. 11.5%, respectively). The most frequent complications were device breakage for gastrostomies and the tube being accidentally removed for nasogastric tubes.

No significant differences in nutrition were observed between the two groups. Interviews with parents revealed varied experiences regarding the choice of feeding tubes. While some parents felt empowered to make the decision, others relied heavily on medical advice. Various factors influenced their choices, including the child’s age, expected usage duration, and personal experiences. Regardless of the tube type, parents were reassured that their child’s nutritional and medicinal needs were met.

Both tubes showed similar outcomes and frequency of complications. Gastrostomy complications were mostly minor but occurred frequently. Despite this, parents found the benefits of a gastrostomy were more than the risks. If a child is preparing for a BMT and nasogastric tube feeding may not be feasible, a gastrostomy should be considered an alternative. This decision should be based on risks, benefits, and family preferences.

Source: https://ebmt2023.abstractserver.com/program/#/details/presentations/474

Clinical Trial: https://classic.clinicaltrials.gov/ct2/show/NCT04804631

Evans, J., Green, D., O’Connor, G., Lanigan, J., Gibson, F. NG14-03 SIMILAR OUTCOMES BUT DIFFERENT EXPERIENCES OF GASTROSTOMY VERSUS NASOGASTRIC TUBE FEEDING IN PEDIATRIC BONE MARROW TRANSPLANT: A MIXED METHODS STUDY. 

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