26 Efficacy of the use of gastrostomy feeding on the growth of children with chronic diseases
Bibliographic record
Abstract
Objectives Chronic diseases are the primary burden of diseases suffered in the children and young population. As a result of advances in paediatrics care, many more children affected by chronic diseases have their consequences enduring into adulthood, including that of growth, due to impaired mechanisms in oral feeding. The use of gastrostomy can help to alleviate this, as it provides a direct route for food to enter the GI tract. Table 1 shows the types of chronic diseases with the use of gastrostomy feeding. The aim of the literature review is to evaluate the efficacy of the use of gastrostomy feeding on the long term growth of children with chronic diseases based on several anthropometric parameters, as well as assessing its impact on overall health, quality of life and associated complications. Methods 15 papers were identified through the Medline database using the terms: ‘Gastrostomy’, ‘growth’, ‘child’ and ‘chronic disease’ after filtering through inclusion and exclusion criteria. Results Table 2 shows the results of the anthropometric variables. ZBMI/A, ZW/A, ZW/H and ZH/A all improved post gastrostomy insertion to follow-up. Long term follow-up to 5 years post-removal reveals that the ZBMI/A and ZW/A have not changed much significantly, implying that the use of gastrostomy does not predispose to obesity in later life. Early use of gastrostomy has been shown to be effective in preventing long-term adverse outcomes, such as irreversible cognitive delay and growth suppression in children suffering from neurodevelopmental disabilities and chronic kidney disease respectively. The effects on ZH/A seem to be less and not as long-lasting; and there seems to be other processes that cause the predisposition of growth failure in children with chronic kidney disease, which is not helped by the use of gastrostomy. Conclusions Gastrostomy is an effective method of supplementary enteral feeding for children with chronic diseases, should oral feeding mechanisms fail to achieve the appropriate nutritional and energy intake required for their growth. Although there are potentially serious complications linked to their use and it may be ‘unappealing’ to parents initially, its benefits on the growth, overall health and quality of life of the affected children and their carers far outweigh their associated risks. The importance of collaboration between the multidisciplinary team and the children and their carers must be stressed in order to maximise its usefulness, especially during early stages of their disease, in order to prevent from long term irreversible adverse outcomes on growth. References Coleman JE, Norman LJ, et al. J Ren Nutrition July 1999. Cooke S, Hooper V, et al. Canadian Journal of Dietetic Practice and Research 2005. Martinez-Costa C, Calderon, et al. Nutrients April 2019. Miller T, et al. Paediatrics October 1995.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.011 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.003 |
| Bibliometrics | 0.004 | 0.004 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".