Implementing an early feeding pathway post gastrostomy insertion reduces inpatient stay

Infographic · Aug 2020 · 1 min read

In brief

Retrospective study of 116 pediatric gastrostomy patients demonstrated that an early feeding protocol (starting 2 hours post-procedure) reduced hospital stay by 5 hours compared to traditional surgeon-preference approaches, without increasing complication rates. The pathway safely advances feeds to full volume within 8 hours.

Early feeding (starting 2 hours post-op at 50% volume) after pediatric gastrostomy insertion is safe with no increase in complications
Standardized early feeding pathway reduced median hospital stay by 5 hours (28 vs 33 hours) compared to surgeon preference approach
Complication rates remained low and equivalent between groups (immediate 8.2% vs 7.3%, early 12% vs 16%)
Protocol: 50% feed at 2 hours, then 100% at 5 and 8 hours post-procedure enables safe same-day or next-day discharge
116-patient study demonstrates early feeding protocols can reduce resource utilization without compromising patient safety

Written by the GCMD Library team from the infographic.

The infographic uses a red and white color scheme with a bold red header banner. It shows a simple anatomical diagram of a stomach with gastrostomy tube on the left, followed by a comparison table with four outcome columns. Each outcome is illustrated with simple black icons (hospital bed, house, medical equipment) and displays before/after statistics in black and red numbers.

Background

There is no consensus regarding optimal postoperative feeding strategy following gastrostomy insertion in children. The aim of this study was to determine whether implementing an early postoperative feeding pathway reduces length of stay (LOS) without increasing complications.

Methods

A retrospective case note review of all children having a new gastrostomy inserted during a one-year period prior to (July 2016–July 2017) and following (July 2017–July 2018) pathway introduction was performed. Children unable to follow the pathway for coexisting medical or nutritional reasons were excluded. The pathway comprised feeding 50% of normal feed 2 hours postprocedure, followed by 100% of normal feed at 5 and 8 h. Previously, patients were fed postoperatively according to surgeon preference.

Results

116 cases met inclusion criteria, 55 prior to and 61 after pathway implementation. Children following the early feeding pathway had a shorter postoperative LOS than the historical group (median 28 vs 33 h, p < 0.003), while immediate (<72 h) and early (<30 day) complication rates were similar (8.2 vs 7.3%, p = 1.00 and 12 vs 16%, p = 0.59, respectively).