Tolerability and safety of early enteral nutrition in children after percutaneous endoscopic gastrostomy placement: A multicentre randomised controlled trial

Wiernicka, Anna; Matuszczyk, Małgorzata; Szlagatys-Sidorkiewicz, Agnieszka; Landowski, Piotr; Toporowska-Kowalska, Ewa; Gębora-Kowalska, Beata; Popińska, Katarzyna; Sibilska, Marta; Grzybowska-Chłebowczyk, Urszula; Więcek, Sabina; Hapyn, Ewa; Blimke-Kozieł, Karolina; Kierkuś, Jarosław

doi:10.1016/j.clnu.2018.08.018

Cited by 13 publications

(18 citation statements)

References 12 publications

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“…Similar median hospital stays (five days) were seen in both early and delayed feeding [19,20,26]. The effect of early feeding on the length of hospital stay (hours) after PEG placement showed little to no difference in comparison to delayed feeding (195 patients): MD −7.47 h, 95% CI −25.16 to 10.21; I 2 = 95%) ( Figure 3) [19,20,26].…”

Section: Length Of Hospital Staymentioning

confidence: 62%

“…Figure 1 shows the flow of the selection of articles that compared early versus delayed feeding after the PEG placement in children. A total of 12,672 records were identified, and a total of three RCTs met the inclusion criteria [19,20,26]. Thus, three studies with 208 patients were included in the meta-analysis [19,20,26].…”

Section: Data Synthesismentioning

confidence: 99%

“…A total of 12,672 records were identified, and a total of three RCTs met the inclusion criteria [19,20,26]. Thus, three studies with 208 patients were included in the meta-analysis [19,20,26]. Table 1 shows a summary of the characteristics of the reviewed studies [19,20,26].…”

Section: Data Synthesismentioning

confidence: 99%

“…Thus, three studies with 208 patients were included in the meta-analysis [19,20,26]. Table 1 shows a summary of the characteristics of the reviewed studies [19,20,26]. Early feeding was defined as within 3 h in two studies and within 4 h in one study.…”

Section: Data Synthesismentioning

confidence: 99%

“…In a sub-analysis, one study showed that early feeding without antibiotics resulted in a slight reduction in the length of hospital stay relative to delayed feeding (MD −21.60 h, 95% CI −22.86 to −20.34) [20], while early feeding with antibiotics did not affect the length of stay in two studies (MD 0.28 h, 95% CI −6.49 to 7.06; I 2 = 0%) (Appendix A Figure A4) [19,26].…”

Section: Length Of Hospital Staymentioning

confidence: 99%

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Early versus Delayed Feeding after Percutaneous Endoscopic Gastrostomy Placement in Children: A Meta-Analysis

Watanabe

Kotani

2020

Children

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Early feeding after percutaneous endoscopic gastrostomy (PEG) placement is an accepted practice in the treatment of adult patients and the knowledge is clinically extrapolated in the treatment of children. To verify this treatment in children—as there are some specific features of PEG-related practices in children—the present study aimed to review meta-analyses of early feeding (within 4 h) after PEG placement in children. We searched the PubMed database for articles published until July 2020. A quality assessment was performed using the Grading of Recommendations, Assessment, Development, and Evaluation method. Three randomized controlled trials (208 patients) were eligible for inclusion. No patients died within 72 h. Early feeding resulted in little to no difference in the length of hospital stay (mean difference [MD] −7.47, 95% confidence interval [CI] −25.16 to 10.21; I2 = 95%) and vomiting events (risk ratio 0.84, 95% CI 0.55 to 1.31; I2 = 0%). In a subgroup analysis, early feeding without antibiotics reduced the length of hospital stay in one study (MD −21.60, 95% CI −22.86 to −20.34) but early feeding with antibiotics did not affect the length in two studies (MD 0.28, 95% CI −6.49 to 7.06; I2 = 0%). Overall, the certainty of the evidence was not very high. In summary, early feeding after PEG placement may be a safe alternative to delayed feeding in children. The findings in children seemed similar to those in adults, while there is a need for further studies that specifically investigate PEG placement-related practices in children.

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