Bolus versus continuous feeding regimens post gastrostomy tube placement in children
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In brief
In brief
Prospective randomized trial comparing bolus versus continuous feeding regimens after pediatric gastrostomy tube placement found no clinically significant differences in feeding tolerance or complications at one month. Both approaches achieved similar times to goal feeds, though bolus feeding required more modifications in the first two weeks and showed higher leakage rates during week two.
Written by the GCMD Library team from the article.
Abstract
Background/purpose
Owing to the frequency of gastrostomy tube placement in children and the numerous regimens used to start feeds after placement we attempted to see if it matters if the initial feeds after a gastrostomy tube placement are provided in a bolus or continuous manner.
Methods
Using a prospective randomized trial, children were randomized to initial bolus or continuous chimney feeding after gastrostomy tube placement. Feeding tolerance and complications related to the gastrostomy tube were collected for 4 weeks after placement.
Results
Demographics were similar in the two groups. Times to goal feeds were similar in both groups, but in the first two weeks more feeding modifications were required in the bolus group. Other than the rate of leakage during the second week after placement which occurred more in the bolus group, all other clinical outcomes were similar in the two groups.
Conclusions
Other than minor, clinically insignificant differences noted above, the method of initial feeding after a gastrostomy tube placement does not affect feeding tolerance or gastrostomy tube complication in the first month after placement.
Level of evidence
Therapeutic, level II.