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Neuropediatrics 2021; 52(04): 326-332
DOI: 10.1055/s-0041-1731007
Original Article

Percutaneous Endoscopic Gastrostomy Feeding in Children with Cerebral Palsy

Hasret Ayyildiz Civan 
1   Department of Pediatric Gastroenterology, Hepatology and Nutrition, Bakırköy Dr. Sadi Konuk Research and Training Hospital, University of Health Sciences, Istanbul, Turkey
,
Gonca Bektas 
2   Department of Pediatric Neurology, Bakırköy Dr. Sadi Konuk Research and Training Hospital, University of Health Sciences, Istanbul, Turkey
,
Ali Evrim Dogan 
3   Nutricia, Advanced Medical Nutrition, Medical Department, Istanbul, Turkey
,
Fatih Ozdener 
4   Department of Pharmacology, Bahcesehir University, School of Medicine, Istanbul, Turkey
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Abstract

Aim The prevalence of congenital cerebral palsy (CP) worldwide ranges from 0.15 to 0.4%. CP causes several gastrointestinal complications that inhibit normal eating behavior. This single-center observational study aimed to determine the tolerability and benefits of percutaneous endoscopic gastrostomy (PEG) in pediatric CP patients with malnutrition.

Materials and Methods The study included 41 pediatric CP patients with malnutrition. All patient data were retrospectively obtained from Bakırköy Dr. Sadi Konuk Research and Training Hospital, Department of Pediatric Gastroenterology, Hepatology, and Nutrition, Istanbul, Turkey. In addition to baseline measurements of weight, height, triceps skinfold thickness, 1,25-hydroxyvitamin D3, folate, iron, zinc, vitamin B12, hemoglobin, and mean corpuscular volume, data analyzed included follow-up measurements recorded at 3 and 6 months of PEG (standard polymeric enteral supplementation as 1.0 kcal mL–1).

Results There was significant improvement in both height, weight, and triceps skinfold thickness in all patients at 3 and 6 months of PEG (p < 0.05). In terms of blood parameters, there was not significant improvement, except that the number of patients with a low hemoglobin count significantly decreased at 3 and 6 months of (p = 0.022). Moreover, the number of patients with vomiting after PEG also significantly decreased at 3 and 6 months of (p = 0.004).

Conclusion PEG significantly improves malnutrition in pediatric CP patients and does not cause any major complications. Based on these findings, we think PEG is a beneficial and cost-effective intervention with a high rate of tolerability in pediatric CP patients with malnutrition.

Keywords

cerebral palsy - malnutrition - pediatric - neurological disorders

Authors' Contribution

All authors contributed to the conception and design of the work, interpretation of data, drafting the work, and revising it critically for important intellectual content. H.A.C. and G.B. contributed to retrospective acquisition of the data. All authors validate the final approval of the version to be published and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.


Financial Disclosure

The authors declare there are no financial or otherwise—related to the material presented herein.


Ethical Approval and Informed Consent

This study was conducted according to the guidelines laid down in the Declaration of Helsinki and all procedures involving research study participants were approved by the Bakirköy Dr. Sadi Konuk Research and Training Hospital Ethics Committee (decision number 2019–23–11, dated 25/11/2019). Written informed consent was obtained from all patients.




Publication History

Received: 03 December 2020

Accepted: 11 April 2021

Article published online:
30 June 2021

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