Total parenteral nutrition (TPN) has been the standard method of nutrition support for children with cancer receiving intensive chemotherapy or bone marrow transplantation who are taking inadequate calories at the time of hospital discharge. In an effort to reduce costs and improve outcome, we have been using enteral tube feedings in these children, both in hospital and at home. Between 1995 and 1997, 10 children with cancer and 1 child receiving intensive chemotherapy for disseminated Langerhan's cell histiocytosis received home enteral tube feedings. Small (6F or 8F) nasogastric (NG) tubes were used in 9 (82%) children, and 2 (18%) children were fed via percutaneous gastrostomies (G-tube). Home enteral tube feedings were administered for a total of 512 days (NG = 188 and G-tube = 324). The tubes were well tolerated, and the children had minimal complications despite neutropenia and thrombocytopenia. The cost of the home enteral tube feedings in these 11 children was $31,315 less than the cost of TPN.
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