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Tube weaning nutrition

Tzippora Shalem, Akiva Fradkin, Marguerite Dunitz-Scheer, Tal Sadeh-Kon, Tali Goz-Gulik, Yael Fishler, Batia Weiss
BACKGROUND: Children dependent on gastrostomy tube feeding and those with extremely selective eating comprise the most challenging groups of early childhood eating disorders. We established, for the first time in Israel, a 3 week intensive weaning and treatment program for these patients based on the "Graz model." OBJECTIVES: To investigate the Graz model for tube weaning and for treating severe selective eating disorders in one center in Israel. METHODS: Pre-program assessment of patients' suitability to participate was performed 3 months prior to the study, and a treatment goal was set for each patient...
June 2016: Israel Medical Association Journal: IMAJ
Yaron Avitzur, Glenda Courtney-Martin
Enteral autonomy and freedom from parenteral nutrition dependency is the ultimate therapeutic goal in children with intestinal failure. This can be achieved following attainment of bowel adaptation in conditions such as short bowel syndrome. Enteral nutrition is a major therapeutic cornerstone in the management of children with intestinal failure. It promotes physiological development, bowel adaptation and enhances weaning from parenteral nutrition. The optimal method of delivery, type of nutrients, timing of initiation, promotion of feeds and transition to solid food in children with short bowel syndrome are debated...
April 2016: Best Practice & Research. Clinical Gastroenterology
Ann M Davis, Kelsey Dean, Hayat Mousa, Sarah Edwards, Jose Cocjin, Osama Almadhoun, Jianghua He, Amanda Bruce, Paul E Hyman
OBJECTIVE: To assess the role of amitriptyline in the effectiveness of an outpatient protocol for weaning medically complicated children from tube to oral feeding. STUDY DESIGN: Twenty-one children seen in multidisciplinary outpatient feeding teams across 4 sites were recruited to a randomized placebo-controlled trial of a 6-month outpatient treatment protocol with behavioral, oral-motor, nutrition, and medication components. RESULTS: All of the children who completed the 6-month program (73%) were weaned to receive only oral feeding, regardless of group assignment...
May 2016: Journal of Pediatrics
Ahmed M A Mohammed, Robert J Dennis
A patient with Prader-Willi Syndrome was admitted to the ICU with features of recurrent acute gastric dilatation, aspiration pneumonia and a massive pulmonary embolus. He was initially managed with intubation, assisted ventilation, intravenous fluids and anticoagulation. Decompression of the stomach was achieved with a nasogastric tube. After ventilator weaning, he did not tolerate the nasogastric intubation that led to a further episode of aspiration pneumonia as a result of non-resolving gastric dilatation...
2016: Journal of Surgical Case Reports
Charlotte Wright
Long term enteral feeding is widely used to provides vital support for infants and children unable to feed orally, but once medically stable the transition to a normal diet can be difficult. Other children may need to commence tube feeding later in childhood because of difficulties associated with neurodisability, but recognising which children will benefit from tube feed is not straightforward. The Royal Hospital for Sick Children, Yorkhill set up a multidisciplinary feeding team in 2002 to help avoid unnecessary tube feeding...
2013: BMJ Quality Improvement Reports
José Antonio Serrano Reina, Teresa Nestares Pleguezuelo, Ma José Muñoz Alférez, Javier Díaz Castro, Ma Inmaculada López Aliaga
OBJECTIVE: in spite of the high incidence/prevalence of iron deficiency anemia (IDA) and the beneficial effects derived from the consumption of goat milk, scarce is known about the recovery of the anemia following a balanced diet accompanied by the intake of goat milk of goat. The aim of the current study is to assess, in rats with experimentally induced nutritional iron deficiency anemia, the effects of goat or cow milk-based diets, supplied during 30 days, on the recovery of the anemia and the efficiency of regeneration of the hemoglobin...
2015: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
Zahra Khan, Sabine Marinschek, Karoline Pahsini, Peter Scheer, Nicholas Morris, Berndt Urlesberger, Marguerite Dunitz-Scheer
OBJECTIVE: The aim of the present study was to assess the nutritional status and growth of medically fragile children receiving long-term enteral nutritional support (ENS). METHODS: A retrospective cross-sectional survey was conducted at a tertiary-level pediatric hospital. Growth features and nutritional intake of children (n = 287) receiving ENS were evaluated. During a period of 5 years (2009-2013), study patients in the age group of 1 to 36 months had been referred for the explicit reason of tube weaning...
January 2016: Journal of Pediatric Gastroenterology and Nutrition
Guoyu Zhang, Jianfeng Zou
OBJECTIVE: To explore the application of enteral immune nutrition preparation for chronic obstructive pulmonary disease (COPD) patients and examine the improving effects on nutritional status, immune status and acute inflammatory reaction. METHODS: A total of 60 cases of hospitalized COPD patients on mechanical ventilation in intensive care unit (ICU) were randomly divided into immune nutrition group (containing essential fatty acids, omega-3 fatty acids, energy 1...
May 19, 2015: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Matthew P G Barnett, Emma N Bermingham, Wayne Young, Shalome A Bassett, John E Hesketh, Anabel Maciel-Dominguez, Warren C McNabb, Nicole C Roy
During pregnancy, selenium (Se) and folate requirements increase, with deficiencies linked to neural tube defects (folate) and DNA oxidation (Se). This study investigated the effect of a high-fat diet either supplemented with (diet H), or marginally deficient in (diet L), Se and folate. Pregnant female mice and their male offspring were assigned to one of four treatments: diet H during gestation, lactation and post-weaning; diet L during gestation, lactation and post-weaning; diet H during gestation and lactation but diet L fed to offspring post-weaning; or diet L during gestation and lactation followed by diet H fed to offspring post-weaning...
May 2015: Nutrients
A Ramos-Fransi, R Rojas-García, S Segovia, C Márquez-Infante, J Pardo, J Coll-Cantí, I Jericó, I Illa
BACKGROUND AND PURPOSE: Myasthenia gravis (MG) may become life-threatening if patients have respiratory insufficiency or dysphagia. This study aimed to determine the incidence, demographic characteristics, risk factors, response to treatment and outcome of these life-threatening events (LTEs) in a recent, population-based sample of MG patients. METHODS: A retrospective analysis of MG patients who presented with an LTE between 2000 and 2013 was performed. Participants were identified from a neuromuscular diseases registry in Spain that includes 648 patients with MG (NMD-ES)...
July 2015: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Caroline M Hartdorff, C M Frank Kneepkens, Anita M Stok-Akerboom, Elisabeth M van Dijk-Lokkart, Michelle A H Engels, Angelika Kindermann
BACKGROUND: Children with congenital malformations, mental retardation, and complex early medical history frequently have feeding problems. Although tube feeding is effective in providing the necessary energy and nutrients, it decreases the child's motivation to eat and may lead to oral aversion. In this study, we sought to confirm our previous results, showing that a multidisciplinary clinical hunger provocation program may lead to quick resumption of oral feeding. METHODS: In a crossover study, 22 children of 9 to 24 months of age who were fully dependent on tube feeding were randomly assigned to one of two groups: group A, intervention group (2-week multidisciplinary clinical hunger provocation program); and group B, control group (4-week outpatient treatment by the same multidisciplinary team)...
April 2015: Journal of Pediatric Gastroenterology and Nutrition
Sarah Edwards, Ann M Davis, Amanda Bruce, Hayat Mousa, Beth Lyman, Jose Cocjin, Kelsey Dean, Linda Ernst, Osama Almadhoun, Paul Hyman
Enteral nutrition is the practice of delivering nutrition to the gut either orally or through a tube or other device. Many children are reliant on enteral feedings to either supplement their nutrition or as a complete source of their nutrition. Managing children on tube feedings requires a team of providers to work through such dilemmas as feeding schedules, weaning from tube feeding, sensory implications of tube feeding, treatment of pain or nausea associated with eating, oral-motor issues, and behavioral issues in the child and family...
July 2016: JPEN. Journal of Parenteral and Enteral Nutrition
Sabine Marinschek, Marguerite Dunitz-Scheer, Karoline Pahsini, Birgit Geher, Peter Scheer
AIM: The Graz model of tube weaning has been internationally recognised as a successful and rapid tube weaning program. Beside the onsite treatment option, a telemedical counselling was specifically developed in 2009. This study aims to show outcomes of this newly invented treatment in a large sample of patients. METHODS: Our retrospective open-label study compared success of onsite versus telemedical Graz-based weaning methods for patients with diverse clinical diagnoses with either nasogastric, gastric or jejunal tubes...
November 2014: Journal of Paediatrics and Child Health
Alison Y Gardiner, David G Fuller, Peter J Vuillermin
AIM: The aim of this study was to describe paediatric feeding-tube weaning practice in Australian children's hospitals and to compare this with practice in tube weaning programmes internationally. METHODS: A literature review regarding tube weaning practices was conducted to inform questionnaire design. Six Australian children's hospitals and six international paediatric service providers completed a written questionnaire. RESULTS: Four of six Australian children's hospitals surveyed reported that they have adopted informal paediatric tube weaning practices; four of six lacked clinical practice guidelines (CPGs), and five of six lacked a clearly defined case leadership...
August 2014: Journal of Paediatrics and Child Health
Jessica Brown, Cindy Kim, Audrey Lim, Shonda Brown, Hema Desai, Leigh Volker, Mitchell Katz
OBJECTIVES: The present study evaluated the effectiveness of a multidisciplinary intensive inpatient model for gastrostomy tube (GT) weaning. METHODS: A retrospective chart review was completed on 30 GT-dependent children, ages 3.9 (±1.4) years, admitted to the inpatient feeding program (length of stay 19 days) from May 2009 to December 2011. Administered GT calories were decreased on admission by an average of 73% from home regimen. Patients were offered 3 meals and 2 to 3 snacks/day, including 3 intensive feeding therapy sessions (Monday to Friday), along with psychosocial support, nutrition guidance, and behavioral therapy...
June 2014: Journal of Pediatric Gastroenterology and Nutrition
Christian-Alexandre Castellano, Mélanie Plourde, Sandie I Briand, Paul Angers, Alain Giguère, J Jacques Matte
The aim of the present study was to perform a short-term safety evaluation of dietary mono-conjugated α-linolenic acid isomers (CLNA; c9-t11-c15-18:3+c9-t13-c15-18:3) using a neonatal pig model. CLNA diet was compared with three other dietary fats: (1) conjugated linoleic acid (CLA; c9-t11-18:2+t10-c12-18:2), (2) non-conjugated n-3 PUFA and (3) n-6 PUFA. Thirty-two piglets weaned at 3 weeks of age were distributed into four dietary groups. Diets were isoenergetic and food intake was controlled by a gastric tube...
February 2014: Food and Chemical Toxicology
Shigemitsu Suzuki, Kensuke Kiyokawa, Katsuhiko Nakamura, Hideyuki Kashikie, Keiichi Akaiwa, Koichi Watanabe, Shigeru Hara
A 76-year-old man was admitted to our department to undergo surgical treatment for aortic valve regurgitation. On physical examination, a bowl-shaped concavity was noted. Chest computed tomography revealed left-sided heart displacement by severe pectus excavatum with a Haller index of 6.40. Considering the postoperative cardiopulmonary complications that may result from mechanical compression due to uncorrected sternal deformities, we decided to perform a simultaneous aortic valve replacement and pectus excavatum correction...
2014: Annals of Thoracic and Cardiovascular Surgery
Alan H Silverman, Midge Kirby, Lisa M Clifford, Elizabeth Fischer, Kristoffer S Berlin, Colin D Rudolph, Richard J Noel
OBJECTIVES: Limited published data describe the long-term effects of behavioral strategies to wean children from gastrostomy tube (GT) feeding dependence. This study presents data relating to nutritional and psychosocial outcomes observed during a 1-year period in medically complex GT feeding-dependent patients who completed an inpatient behavioral-based tube weaning protocol. METHODS: This was a retrospective study of prospectively and retrospectively collected data associated with a clinical cohort of 77 children diagnosed as having a feeding disorder, GT feeding dependence (>1 year), and an inability to maintain acceptable growth via oral feeding completing an inpatient tube weaning protocol...
November 2013: Journal of Pediatric Gastroenterology and Nutrition
Christina Egnell, Staffan Eksborg, Lena Grahnquist
BACKGROUND: The aim of this study was to report on the clinical outcome and safety of jejunostomy tube feeding used in our clinical setting for more than 14 years. MATERIAL AND METHODS: A retrospective study of all children who underwent a surgical catheter jejunostomy placement between July 1996 and March 2010 was conducted. Data were collected regarding the outcome and complications. RESULTS: Thirty-three children (14 girls) were included...
July 2014: JPEN. Journal of Parenteral and Enteral Nutrition
M Terré, E Pedrals, A Dalmau, A Bach
The objective of this study was to determine whether the improvement of performance of young calves associated with the supplementation of chopped grass hay reported in some studies is due to an increase in the total neutral detergent fiber (NDF) content of the consumed diet or to the provision of chopped grass hay. Sixty-three Holstein calves [9±4.4 d old; mean ± standard deviation (SD)] were randomly distributed in 4 treatments resulting from the combination of 2 levels of NDF content of a pelleted starter and the supply or absence of forage provision: low-NDF starter (18%) with or without chopped oat hay, and high-NDF starter (27%) with or without chopped oat hay...
August 2013: Journal of Dairy Science
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