Evidence map›Paper›PMID 41885771›Full record

GuidelineJPEN. Journal of parenteral and enteral nutrition2026

Guidelines for replacement of a balloon gastrostomy tube in infants and pediatric patients: The American Society for Parenteral and Enteral Nutrition.

Beth Lyman, Loren Berman, Kathleen Carr, Cailin Frank, Peggi Guenter, Rachel Kassel, Janet Kimble, Carol McGinnis, Silvana Oppedisano, Elizabeth A Paton and 6 more

Abstract readPractice Guideline
PubMed Full text at PMC Publisher
In one paragraph

Guideline in JPEN. Journal of parenteral and enteral nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Guideline
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Beth LymanNutrition, Support Nurse Consultant, Smithville, Missouri, USA.
Loren BermanNemours Children's Health, Wilmington, Delaware, USA.
Kathleen CarrBoston Children's Hospital, Boston, Massachusetts, USA.
Cailin FrankLe Bonheur Children's Hospital, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
Peggi GuenterAmerican Society for Parenteral and Enteral Nutrition, Silver Spring, Maryland, USA.ORCID https://orcid.org/0000-0003-2850-246X
Rachel KasselDepartment of Pediatrics, Division of Pediatric Gastroenterology, Hepatology, and Nutrition, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, USA.ORCID https://orcid.org/0000-0001-7953-5953
Janet KimbleCedars-Sinai Medical Center, Los Angeles, California, USA.
Carol McGinnisSanford USD Medical Center, Sioux Falls, South Dakota, USA.ORCID https://orcid.org/0000-0002-2014-8163
Silvana OppedisanoDivision of Paediatric Medicine, G-Tube Feeding Program, The Hospital for Sick Children, Toronto, Ontario, Canada.
Elizabeth A PatonDepartment of Acute and Tertiary Care, College of Nursing, Le Bonheur Children's Hospital, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
Gina RempelDepartment of Pediatrics and Child Health, Nutrition Support and Complex Care, HSC Winnipeg, Shared Health, Winnipeg, Manitoba, Canada.
Derek S WakemanUniversity of Rochester Strong Memorial Hospital, Rochester, New York, USA.ORCID https://orcid.org/0000-0002-2248-7070
David D ChurchDepartment of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.ORCID https://orcid.org/0000-0003-4918-5037
Jacob T MeyPennington Biomedical Research Center, Baton Rouge, Louisiana, USA.ORCID https://orcid.org/0000-0001-6826-7762
Sarah PetersonDepartment of Clinical Nutrition, Rush University Medical Center, Chicago, Illinois, USA.ORCID https://orcid.org/0000-0002-4821-5196
Liam McKeeverDepartment of Clinical Nutrition, College of Health Sciences, Rush University, Chicago, Illinois, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBalloon gastrostomy tube (BGT) placements are increasing due to their ability to facilitate care of medically complex children. Management for routine and nonroutine tube replacement, including verification of proper replacement, lacks standardization, varying widely among different institutions and settings. Currently, no overall standard of care exists for placement verification following BGT replacement, which can occur anywhere. This guideline provides recommendations on topics surrounding best practices, timing, and education confirming newly replaced BGTs.

methodsAn interdisciplinary team developed key questions and performed a systematic search of the PubMed/MEDLINE, EMBASE, CINAHL, and Cochrane Central databases from January 2008 to October 2025. Recommendations were developed for questions concerning timing of routine BGT replacement, weighing the impact of comorbidities and extenuating circumstances, standard and additional methods to confirm BGT replacement position, confirmation of placement when the BGT is traumatically or accidentally dislodged, and how care bundles and clinician education around BGT replacement impact patient outcomes.

resultsThree studies were included (one validation and two pre-post studies). Recommendations were made for when additional measures beyond aspiration of gastric contents (e.g., radiographic contrast study) are indicated, use of ultrasound in lieu of a contrast study, what care bundle components improve patient outcomes, and what topics should be covered in clinician education for BGT replacement confirmation.

conclusionThis guideline provides placement confirmation guidance for clinicians who perform routine and nonroutine BGT replacements, identifies areas for research, and suggests the use of care bundles to standardize care of this population. This paper was approved by the ASPEN Board of Directors.

Indexed as

Enteral NutritionGastric BalloonGastrostomyIntubation, GastrointestinalParenteral NutritionChildHumansInfantSocieties, MedicalUnited Statesballoon gastrostomy tubecare bundlesclinician educationpediatricsplacement verificationpractice guidelineradiologic contrast studytube dislodgementtube replacementultrasound

Identifiers

PMID41885771
PMCPMC13169229

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.