Issn Print: 0277-2116

Publication Date: 2004/06/01


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P1144 GASTROSTOMY TUBE FEEDING AND THE RISK OF RESPIRATORY MORBIDITY

J. S. Morrice; A. Vernon Roberts; H. Grant; M. Eltumi; P. B. Sullivan

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Author Information: Department of Paediatrics, University of Oxford,

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Introduction: Gastrostomy feeding in children with cerebral palsy improves growth and caretaker quality of life. Strauss et al (1), however, found a relative risk of mortality associated with feeding tube of 2.1. This was attributed to increased pulmonary disease secondary to overly vigorous nutrition and subsequent aspiration. The aim of this investigation was to examine the occurrence of respiratory morbidity before and after gastrostomy tube insertion.
Methods: We investigated 138 children in two separate studies.
1. A retrospective case note analysis of children (n=81) receiving gastrostomy between Jan 97– Nov 02. Documented chest infections ± hospital admissions were recorded for 6 months prior to and 12 months following gastrostomy insertion.
2. A prospective study of different children (n=57) with severe neurological disabilities receiving gastrostomy between Nov 00 and Dec 02. Parents completed a questionnaire prior to (visit 1) and 6 and 12 months (visits 2 & 3) following the gastrostomy detailing the number of chest infections that required antibiotics and/or hospital admission.
Results:
1. In the retrospective study: 34/81 (42%) had a proven unsafe swallow; 25/81 (31%) proven GOR and 30/81 (37%) had fundoplication. Following gastrostomy there was a reduction in documented chest infections from 37/81 (45.7%) to 26/81 (30.9%) (p=0.58). There was no difference in the number of hospital admissions for chest infection (11.1% v 12.3%). Four died with two deaths directly attributable to chest infection.
2. In the prospective study: The mean number of chest infections requiring antibiotics was 1.8 on visit one and 0.9 on visit 3 (p=0.07) with hospital admissions for chest infections falling significantly from 0.5 to 0.09 (p=0.04).
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