A REVIEW OF 101 CHILDREN WITH GASTRO-JEJUNAL FEEDING TUBES INCLUDING THEIR COMPLICATIONS AT BC CHILDREN’S HOSPITAL.

摘要

Background The use of GastroJejunal Tubes (GJTs) is an increasingly common method for providing post-pyloric enteral nutrition in pediatric patients. Aims To describe the patients with GJT including the indication, comorbidities including by system, as well as tube related complications. Methods The charts of 101 patients who had a GJT over a one-year period (2019–20) were retrospectively reviewed including demographics, medical diagnoses, information about tube placement, maintenance, and complications including malposition, balloon failure, blockages, and leakages / breaks. Results The top indications for GJT are aspiration and GERD. 73.3% have 3 system comorbidities (ie CNS, GI, Resp). Mean age of GJT placement was 43 months. 78% remain on a PPI and 24% are on a prokinetic. 24% continue to eat some amount orally. Over this one-year period, 92% continue with a GJT (mean duration 4 years, max 15), 4% have reverted back to a G-tube, 1% had a surgical J tube placed, and 3% died (not due to the GJT). Following initial placement, these 101 patients underwent 1194 GJT related procedures, (417 urgent changes, 777 routine changes) with 98.3% technical success. Patients needed an average of one urgent repair per year (3.2/1000 GJT days) and the majority of patients required 1 emergency visit. Those with routine GJT changes seem to have fewer urgent repairs (Figure 1). Conclusions Children with GJT represent a growing complex patient population. GJT are being used for the longer term. Routine maintenance seems supported by our data although doesn’t prevent the need for urgent repairs or other complications. Frameworks and guidelines are needed for this essential technology to improve clinical care.