A clinical consensus paper on jejunal tube feeding in children

IF 3.2 3区医学 Q2 NUTRITION & DIETETICS

Journal of Parenteral and Enteral Nutrition Pub Date : 2024-03-02 DOI:10.1002/jpen.2615

Kathleen H. McGrath MBBS (Hons), Tanya Collins BSc, Annabel Comerford BNutDiet (Hons), Zoe McCallum MBBS, Michaela Comito BNutDiet (Hons), Kim Herbison BHSc, Olivia Rose Cochrane MDiet, Deirdre Mary Burgess BSc, Sarah Kane BHSc (Nut&Diet) (Hons), Keryn Coster BND, Michele Cooper BNurs, Kathryn Jesson BNurs

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引用次数: 0

Abstract

Background

Feeding problems are common in children with complex medical problems or acute critical illness and enteral nutrition may be required. In certain situations, gastric tube feeding is poorly tolerated or may not be feasible. When feed intolerance persists despite appropriate adjustments to oral and gastric enteral regimens, jejunal tube feeding can be considered as an option for nutrition support.

Methods

A multidisciplinary expert working group of the Australasian Society of Parenteral and Enteral Nutrition was convened. They identified topic questions and five key areas of jejunal tube feeding in children. Literatures searches were undertaken on Pubmed, Embase, and Medline for all relevant studies, between January 2000 and September 2022 (n = 103). Studies were assessed using National Health and Medical Research Council guidelines to generate statements, which were discussed as a group, followed by voting on statements using a modified Delphi process to determine consensus.

Results

A total of 24 consensus statements were created for five key areas: patient selection, type and selection of feeding tube, complications, clinical use of jejunal tubes, follow-up, and reassessment.

Conclusion

Jejunal tube feeding is a safe and effective means of providing nutrition in a select group of pediatric patients with complex medical needs, who are unable to be fed by gastric tube feeding. Appropriate patient selection is important as complications associated with jejunal tube feeding are not uncommon, and although mostly minor, can be significant or require tube reinsertion. All children receiving jejunal tube feeding should have multidisciplinary team assessment and follow-up.

查看原文本刊更多论文

关于儿童空肠管喂养的临床共识文件。

背景：患复杂内科疾病或急性危重症的儿童普遍存在喂养问题，可能需要肠内营养。在某些情况下，胃管喂养的耐受性较差或不可行。在适当调整口服和胃肠道治疗方案后仍出现喂养不耐受的情况下，可考虑将空肠管喂养作为营养支持的一种选择：方法：澳大利亚肠外和肠内营养学会（Australasian Society of Parental and Enteral Nutrition）召集了一个多学科专家工作组。他们确定了儿童空肠管喂养的主题问题和五个关键领域。在 Pubmed、Embase 和 Medline 上对 2000 年 1 月至 2022 年 9 月期间的所有相关研究进行了文献检索（n = 103）。根据国家健康与医学研究委员会的指导方针对研究进行评估，以形成声明，并在小组内进行讨论，然后采用改良的德尔菲程序对声明进行投票，以确定共识：结果：针对患者选择、喂食管的类型和选择、并发症、空肠管的临床使用、随访和重新评估这五个关键领域，共制定了 24 项共识声明：空肠管喂养是一种安全有效的方法，可为部分有复杂医疗需求、无法使用胃管喂养的儿科患者提供营养。适当选择患者非常重要，因为空肠管喂养相关的并发症并不少见，虽然大多是轻微并发症，但也可能是严重并发症或需要重新插管。所有接受空肠管喂养的儿童都应接受多学科团队的评估和随访。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Parenteral and Enteral Nutrition 医学-营养学

CiteScore

7.80

自引率

8.80%

发文量

161

审稿时长

6-12 weeks

期刊介绍： The Journal of Parenteral and Enteral Nutrition (JPEN) is the premier scientific journal of nutrition and metabolic support. It publishes original peer-reviewed studies that define the cutting edge of basic and clinical research in the field. It explores the science of optimizing the care of patients receiving enteral or IV therapies. Also included: reviews, techniques, brief reports, case reports, and abstracts.