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Differences in Durability, Dislodgement, and Other Complications With Use of Low‐Profile Nonballoon Gastrostomy Tubes in Children
Author(s) -
Hajjat Temara,
Rahhal Riad M.
Publication year - 2017
Publication title -
nutrition in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.725
H-Index - 71
eISSN - 1941-2452
pISSN - 0884-5336
DOI - 10.1177/0884533616680356
Subject(s) - medicine , gastrostomy , gastrostomy tube , feeding tube , surgery , confidence interval , enteral administration , hazard ratio , tube (container) , sedation , retrospective cohort study , parenteral nutrition , mechanical engineering , engineering
Background: Nonballoon low‐profile gastrostomy tubes (GTs) are used for enteral nutrition support in a subset of pediatric patients with feeding difficulties when use of balloon GTs is problematic. Different nonballoon low‐profile tube types are available, but comparative studies are lacking. Materials and Methods: This was a retrospective cohort study comparing complications and outcomes between different low‐profile nonballoon GTs at a pediatric tertiary care center over 10 years. Results: We identified 43 patients with 160 tube placement procedures, including 93 (58%) BARD tubes (type A) and 67 (42%) Mini‐ONE tubes (type B). Accidental tube dislodgment occurred exclusively with type B (33% vs 0%, P < .0001) with dislodgment occurring at a median of 54 days after placement. Type A GTs were more likely to be changed due to leakage (47% vs 8%, P < .0001). Minor gastrostomy site bleeding was more likely to be seen with type A tube changes (46% vs 7%, P < .0001). Patient sedation or site dilation was rarely needed in either group. Time to tube change was longer in the type B GTs (BARD) ( P = .016) with a median tube survival in the type A and type B groups at 432 and 284 days, respectively, with a hazard ratio of 1.89 (95% confidence interval, 1.2–2.99), but once confounders were accounted for, the effect of tube type was no longer statistically significant. Conclusion: Our study shows that differences exist with use of various low‐profile nonballoon GTs. This should be taken into consideration when counseling families about the most appropriate tube type for their children.