Long‐term Outcomes of an Interdisciplinary Tube Weaning Program

Abstract

Background and Objectives: Children who become tube-dependent need specialized treatment in order to make the transition to oral feeding. Little is known about long-term effects of tube weaning programs. This study analyzes long-term effects (outcome, growth, and nutrition data) in a large sample of formerly tube-dependent children 1 to 6 years after participation in tube weaning programs, based on the “Graz model of tube weaning.” Methods: Parents of children who completed a tube weaning program between 2009 and 2014 (N = 564) were asked to complete a questionnaire on their child's growth and nutrition. Data was analyzed using SPSS V22.0 for Windows (SPSS, Chicago, IL). Results: Response rate was 47.16% (N = 266). Seven children had died between completion of the program and the long-term follow-up. Two hundred and thirty-nine children (92.3%) were still exclusively orally fed 1 to 6 years after completion of the weaning program, 17 children (6.6%) were partially tube-fed. Three children were completely tube-fed (1.1%). Growth data showed no significant changes in zBMI (World Health Organization standards z values for body mass index) between completion of weaning and long-term follow-up. Provided data on nutrition of fully orally fed patients showed that most children (N = 162, 68%) were eating an age-appropriate diet, whereas a small percentage (N = 10, 4%) were fed with a high-caloric formula, a selective diet (N = 12, 5%), or a liquid/pureed diet (N = 55, 23%). Conclusions: Many children who undergo a tube weaning program based on the “Graz model of tube weaning” are able to stay on full oral feeds in the years after completion of the wean without deterioration of growth.

Appetite‐guided approach to pediatric enteral tube weaning in the home setting: A pilot study

“…Survey results support the success of GIE home‐based weaning conducted by parents/caregivers with virtual interdisciplinary team assistance. The GIE treatment success of 84% was comparable to the 60%–92% success rates of other inpatient hunger provocation, home‐based, and telehealth models' 3–11 . GIE wean duration (38–80 days) was longer than inpatient wean programs (7–22 days) but shorter than the 479 days reported by an earlier telehealth method.…”

“…comparable to the 60%-92% success rates of other inpatient hunger provocation, home-based, and telehealth models'. [3][4][5][6][7][8][9][10][11] GIE wean duration (38-80 days) was longer than inpatient wean programs (7-22 days) but shorter than the 479 days reported by an earlier telehealth method.…”

“…3 Inpatient programs using hunger provocation as a motivator to eat through rapid elimination of tube feeds (TFs) over 7-22 days reported success rates of 60%-92%. [3][4][5][6][7][8][9] A home-based program withdrawing TF over 4-10 days reported a success rate of 90%. 10 One telehealth model withdrawing TF over an average of 479 days reported a success rate of 91%.…”

“…Weaning methods differ in settings, durations, and success rates 3 . Inpatient programs using hunger provocation as a motivator to eat through rapid elimination of tube feeds (TFs) over 7–22 days reported success rates of 60%–92% 3–9 . A home‐based program withdrawing TF over 4–10 days reported a success rate of 90% 10 .…”

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

“…Furthermore, the study did not include long-term outcomes, e.g., months or years after discharge, with respect to feeding, weight, and growth development. While long-term outcomes of the "Graz Model of tube weaning" have been recently published [24], a specific analysis for those children born with EA may be beneficial for the future.…”