A descriptive comparison of approaches to paediatric tube weaning across five countries

Gardiner, Alison Y.; Vuillermin, Peter; Fuller, David

doi:10.1080/17549507.2016.1193898

Cited by 19 publications

(28 citation statements)

References 31 publications

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“…Weaning stays offered in international clinics or specialized units use programs closely related to ours with a multidisciplinary approach ( 14 , 15 ). In a recent systematic review, Sharp et al described eight studies describing inpatient stay, only two having similar multidisciplinary team of caregivers as ours ( 16 ).…”

Section: Discussionmentioning

confidence: 99%

A Program for Weaning Children from Enteral Feeding in a General Pediatric Unit: How, for Whom, and with What Results?

et al. 2018

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ObjectiveTo describe a series of children who were hospitalized for a tube-weaning program in the general pediatric ward of a pediatric tertiary university hospital: describe our method, to determine the success rate of our inpatient pediatric tube weaning program, and search for relevant factors linked to its success or failure.MethodWe analyzed the medical files of consecutive children who were hospitalized for gastric-tube weaning over an 8-year period. We analyzed outcomes in terms of feeding and growth with at least 2 years of data. Success (weaning within 3 months) and failure were compared by characteristics of children.ResultsWe included 37 children (29 females) with mean (SD) age 31.4 (21) months. Most had a severe medical history (30% prematurity; 50% intrauterine growth restriction, 50% neurological and genetic anomalies). The weaning program was successful for half of the children. Factors linked to success of the program were female sex (p = 0.0188), normal neurodevelopment (p = 0.0016), nasogastric tube (p = 0.0098), and with <24 months on EF before the stay (p = 0.0309).DiscussionComparing the efficiency of various methods and results among teams was difficult, which indicates the need to establish consensus about the outcome criteria. We confirm the need for these types of stays and programs.

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Section: Discussionmentioning

confidence: 99%

A Program for Weaning Children from Enteral Feeding in a General Pediatric Unit: How, for Whom, and with What Results?

et al. 2018

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“…Interestingly, when respondents selected which health‐care providers, they would prefer to be involved in weaning children from a feeding tube, psychologists were chosen by 45.7% of staff. Currently, this professional group within CHQ were reported to be involved in the care of children weaning from feeding tubes by only 1.4% of respondents, even though research has shown that tube weaning services with a psychologist have a shorter tube weaning duration than those not involving a psychologist 4 …”

Section: Discussionmentioning

confidence: 99%

“…Successful weaning from tube feeding is also dependent upon the involvement of a multidisciplinary team 4,6,22,23 . This evidence‐based practice appeared to have been adopted amongst survey participants.…”

Section: Discussionmentioning

confidence: 99%

“…The basic principles of tube weaning have been identified to be straightforward and should be achievable in any centre that undertakes long‐term tube feeding 1,2 . Many Australian health facilities have an appropriate range of resources that would and have enabled successful transitioning from tube to oral feeding 1,3,4 . The length of tube feeding dependency (TFD) and the quality of intervention children receive, however, differ on a case by case basis 1,3,4 .…”

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confidence: 99%

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Weaning children from temporary tube feeding: Staff survey of knowledge and practices

Syrmis

Frederiksen

Reilly

2020

J Paediatrics Child Health

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Aim To explore the understanding of and practices of health‐care workers in weaning children from feeding tubes. Methods An electronic survey of doctors, nurses, and allied health professionals at Children's Health Queensland obtained demographic information and awareness of various areas of tube feeding management particularly tube weaning. Results The 155 health‐care providers formed three well‐matched groups in terms of number and years of experience. Only 18 had formal training in tube weaning. Participants had high levels of knowledge regarding reasons for commencing and possible complications associated with tube feeding. However, health‐care providers generally were found to have limited to no knowledge of tube weaning practices. Nearly half of participants (46%) did not know the best time to plan for a tube wean and only 16 indicated that they or their work units documented tube exit plans, regardless of type of feeding tube, in children's medical charts. Time frames were rarely included as part of tube exit plans. Participants ranked medical stability and presence of a safe swallow most highly as important indicators for successful tube weaning. Multidisciplinary management was also identified as valuable. Tube weaning was predominately managed by children's primary health unit/service and largely involved a medical officer and dietician. Conclusions Poor awareness of tube weaning practices such as tube exit strategies may be impacting on the quality of care received by children who are tube fed. Future research should be directed towards developing and evaluating guidelines accompanied by educational resources to further advance tube weaning practices.

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“…Families of children with these issues suffer great stress and isolation [4,8,12,23]. A variety of tube weaning methods have been described and discussed [13][14][15][16][17][18] in the literature. Because a dearth of specific information about tube weaning in patients with esophageal atresia exists in recent literature, the authors decided to take a closer look at this population.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of a standardized tube weaning program in pediatric patients with feeding difficulties after successful repair of their esophageal atresia/tracheoesophageal fistula

et al. 2020

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Children born with esophageal atresia (EA) might suffer from significant oral feeding problems which could evolve into tube dependency. The primary aim of the study was to define the outcome of tube weaning in children after successful EA repair and to compare outcomes in children with short gap/TEF (tracheoesophageal fistula) and long-gap EA. Data of 64 children (28 with short-gap EA/TEF with primary anastomosis and 36 with long-gap EA with delayed surgical repair) who participated in a standardized tube weaning program based on the “Graz model of tube weaning” (in/outpatients in an intensive 3-week program, online coaching (Netcoaching) only, or a combined 2-week intensive onsite followed by online treatment “Eating School”) from 2009 to 2019 was evaluated. Sixty-one patients completed the program by transitioning to exclusive oral intake (95.3%). Three children (4.7%) were left partially weaned at the time of discharge. No significant differences could be found between short gap/TEF and long-gap EA group regarding outcomes. Conclusions: The study’s findings support the efficacy of tube weaning based on the published “Graz model of tube weaning” for children born with EA/TEF and indicate the necessity of specialized tube weaning programs for these patients. What is Known:• Children with esophageal atresia/tracheoesophageal fistula often suffer from feeding problems and tube dependency.• Different tube weaning programs and outcomes have been published, but not specifically for children with EA. What is New:• Evaluation of a large sample of children referred for tube weaning after EA repair.• Most children with EA can be weaned off their feeding tubes successfully after attending a specialized tube weaning program.

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A descriptive comparison of approaches to paediatric tube weaning across five countries

Cited by 19 publications

References 31 publications

A Program for Weaning Children from Enteral Feeding in a General Pediatric Unit: How, for Whom, and with What Results?

A Program for Weaning Children from Enteral Feeding in a General Pediatric Unit: How, for Whom, and with What Results?

Weaning children from temporary tube feeding: Staff survey of knowledge and practices

Efficacy of a standardized tube weaning program in pediatric patients with feeding difficulties after successful repair of their esophageal atresia/tracheoesophageal fistula

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