G.C. Josey1, S. Koenig1, V.E. Mortellaro1 1The Children’s Hospital Of Alabama, Division Of Pediatric Surgery, Department Of Surgery, University Of Alabama At Birmingham, Birmingham, AL, USA
Introduction:
Gastrostomy tubes (G-tubes) play a crucial role in enteral feeding for pediatric patients in the Cardiovascular Intensive Care Unit (CVICU). This study seeks to assess the judicious use of G-tubes among the high-risk pediatric CVICU population.
Methods:
A retrospective analysis encompassing 188 patients admitted to the pediatric CVICU between January 2018 and December 2022 was conducted. Judicious G-tube usage was defined as lasting a minimum of 6 months. The reason for G-tube discontinuation was also quantified.
Results:
Among the 188 pediatric CVICU patients assessed, 52.7% were females, born at a median gestational age of 37.6 (IQR: 36.3, 39.0) weeks, and weighing 2.8 (2.4, 3.2) kg at birth. The G-tube at a median age of 11.7 (5.4, 24.0) days and weight of 4.3 (3.4, 5.8) (Table 1). No major post-operative complications were noted. The median duration of G-tube usage was 13.8 (8.2, 22.4) months. Judicious G-tube use was noted in 84.6% (N=159) pediatric CVICU patients. Among 29 patients with G-tube discontinued within 6 months, 11 (37.9%) had adequate weight gain and advancement of oral nutrition, 10 (34.5%) died, and remaining were lost to follow-up.
Conclusion:
This study indicates that majority of pediatric CV ICU patients receiving a G-tube use it judiciously. However, a subgroup of patients may maintain nutrition without G-tube placement and potentially avoid unnecessary abdominal surgery. Further investigations are warranted to develop protocols facilitating proactive enteral nutrition advancement supporting judicious G-tube placements in pediatric CVICU patients.