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Safety of Appetite Manipulation in Children with Feeding Disorders Admitted to an Inpatient Feeding Program.

Publication ,  Journal Article
Pollow, AS; Karls, CA; Witzlib, M; Noel, RJ; Goday, PS; Silverman, AH
Published in: J Pediatr Gastroenterol Nutr
May 2018

OBJECTIVE: Appetite manipulation can be effective in weaning children off gastrostomy tube feeding dependence but can cause dehydration, hypoglycaemia, and ketone body production, which is anorexigenic. As the safety of this approach has not been described, our aim was to describe adverse events observed when weaning children from G-tube dependence using our appetite manipulation protocol. METHODS: This was a retrospective study of prospectively collected data of patients who completed our inpatient tube-weaning protocol. Daily safety parameters included twice-daily urine specific gravities and urine ketones and fasting capillary blood glucose. Graded clinical interventions to manage adverse events were collected. RESULTS: A total of 143 children with a mean age of 4.8 ± 2.4 years were seen in the inpatient feeding program of which 74 (51.7%) were male. The children were hospitalized 10.1 ± 2.5 days with the vast majority being discharged between days 11 and 14. Overall, 78.2% of patients experienced at least 1 adverse event: urine specific gravity >1.020 was seen in 60.5%, ketonuria in 48.9%, and hypoglycemia (≤60 mg/dL) in 13.4%. Only 2 children had blood glucose levels <40 mg/dL and these were corrected with oral supplementation. Graded clinical interventions to manage adverse events included oral rehydration in 89.9% of children and supplemental tube feeding in 25.2%. CONCLUSIONS: Adverse effects are common when appetite manipulation is used to wean children off G-tube dependence. Anticipating, monitoring, and having a clear intervention plan in a closely monitored setting are necessary to safely use this method.

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Published In

J Pediatr Gastroenterol Nutr

DOI

EISSN

1536-4801

Publication Date

May 2018

Volume

66

Issue

5

Start / End Page

e127 / e130

Location

United States

Related Subject Headings

  • Urinalysis
  • Specific Gravity
  • Retrospective Studies
  • Monitoring, Physiologic
  • Male
  • Ketosis
  • Inpatients
  • Hypoglycemia
  • Humans
  • Gastroenterology & Hepatology
 

Citation

APA
Chicago
ICMJE
MLA
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Pollow, A. S., Karls, C. A., Witzlib, M., Noel, R. J., Goday, P. S., & Silverman, A. H. (2018). Safety of Appetite Manipulation in Children with Feeding Disorders Admitted to an Inpatient Feeding Program. J Pediatr Gastroenterol Nutr, 66(5), e127–e130. https://doi.org/10.1097/MPG.0000000000001849
Pollow, Alyssa S., Catherine A. Karls, Mary Witzlib, Richard J. Noel, Praveen S. Goday, and Alan H. Silverman. “Safety of Appetite Manipulation in Children with Feeding Disorders Admitted to an Inpatient Feeding Program.J Pediatr Gastroenterol Nutr 66, no. 5 (May 2018): e127–30. https://doi.org/10.1097/MPG.0000000000001849.
Pollow AS, Karls CA, Witzlib M, Noel RJ, Goday PS, Silverman AH. Safety of Appetite Manipulation in Children with Feeding Disorders Admitted to an Inpatient Feeding Program. J Pediatr Gastroenterol Nutr. 2018 May;66(5):e127–30.
Pollow, Alyssa S., et al. “Safety of Appetite Manipulation in Children with Feeding Disorders Admitted to an Inpatient Feeding Program.J Pediatr Gastroenterol Nutr, vol. 66, no. 5, May 2018, pp. e127–30. Pubmed, doi:10.1097/MPG.0000000000001849.
Pollow AS, Karls CA, Witzlib M, Noel RJ, Goday PS, Silverman AH. Safety of Appetite Manipulation in Children with Feeding Disorders Admitted to an Inpatient Feeding Program. J Pediatr Gastroenterol Nutr. 2018 May;66(5):e127–e130.

Published In

J Pediatr Gastroenterol Nutr

DOI

EISSN

1536-4801

Publication Date

May 2018

Volume

66

Issue

5

Start / End Page

e127 / e130

Location

United States

Related Subject Headings

  • Urinalysis
  • Specific Gravity
  • Retrospective Studies
  • Monitoring, Physiologic
  • Male
  • Ketosis
  • Inpatients
  • Hypoglycemia
  • Humans
  • Gastroenterology & Hepatology