Effectiveness of gastrostomy feeding in children with severe developmental disabilities

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Effectiveness of gastrostomy feeding in children with severe developmental disabilities


Author: Lo, Chui-han Carol
Title: Effectiveness of gastrostomy feeding in children with severe developmental disabilities
Degree: M.Sc.
Year: 2007
Subject: Hong Kong Polytechnic University -- Dissertations.
Children with disabilities -- Complications.
Children with disabilities -- Nutrition.
Developmental disabilities -- Complications.
Enteral feeding.
Ingestion disorders in children.
Department: Dept. of Rehabilitation Sciences
Pages: viii, 94 leaves : ill. ; 30 cm.
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b2174198
URI: http://theses.lib.polyu.edu.hk/handle/200/607
Abstract: This is a retrospective, nonequivalent pretest-posttest control group study to evaluate the effectiveness of gastrostomy feeding in children with severe developmental disabilities. The objectives of the present study were 1) to compare the growth of children before, 6 months, and one year after gastrostomy being done; 2) to compare the frequency of vomiting and episodes of chest infection 12 months before and after the gastrostomy procedure; 3) to compare the growth, frequency of vomiting and incidence of chest infection between the gastrostomy group (GT) and the nasogastric group (NGT) during the period from July 1999 to Sep 2005; and 4) to explore the common complications after gastrostomy. All subjects' patients records from the Developmental Disabilities Unit of an HA hospital of Hong Kong were reviewed. Data collected included demographic data; body weight and height before, 6 months and 12 months after gastrostomy; frequency of vomiting and episodes of chest infection 12 months before and after gastrostomy; and complications experienced after gastrostomy. The gastrostomy group (GT) consisted of 31 subjects (19 males and 12 females) with gastrostomies performed between July 1999 and September 2005. The mean age of the GT group when gastrostomy being performed was 8 years, 1 month (range from 3-19 years, standard deviation [SD] 4 years, 1 month). 32 subjects (17 males and 15 females) with nasogastric tube feeding (NOT) and matching age and conditions were included for comparison. The mean age of the NGT group corresponding to the time of gastrostomy placement was 6 years, 11 months (range from 3-14 years, standard deviation [SD] 2 years, 9 months). There was significant growth by increased Z-score of weight-for-height in the GT group, whereas no significant improvement was noted in the NGT group. Before gastrostomy, the frequency of vomiting and chest infection of the GT group was significantly higher than in the NGT group. At one year after gastrostomy, the difference became non-significant. Frequency of vomiting and episodes of chest infection were significantly reduced in the GT group, especially for those who had antireflux surgery (fundoplication) done, but no significant difference was noted in the NGT group. Common complications identified included granuloma, infection, ulceration, leakage and accidental removal of tube. The results of the present study demonstrate gastrostomy feeding can effectively improve both growth and health status by reducing undesirable symptoms, such as vomiting and chest infection, in children with severe development disabilities. Although there are several minor complications noted, it still serves as an alternative mean of providing nutrition to patients who have feeding difficulties. The result may encourage parent to have prompt decision for gastrostomy for early nutritional intervention which can promote growth and development. The study may also help nurses to develop g astrostomy care protocol accordingly to prevent occurrence of the common complications identified.

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