Abstract
A 57-year-old man presented to the emergency room with neck back pain for about 2 months, unresponsive to nonsteroidal antiinflammatory drugs and progressive course of upper and lower extremity weakness with no sphincter dysfunction..
Highlights
Background and purposeEnteral nutrition via nasogastric tube in acute stroke patients with dysphagia is an important determinant of patient outcomes
There was no significant difference between intermittent and continuous feeding in either incidence of aspiration pneumonia (RR 0.91, 95% CI 0.53-1.57, p=0.74, I2=50%) or diarrhea (RR 1.74, 95% CI 0.704.30, p=0.23, I2=42%)
There was no significant difference between feeding regimes for most outcomes in individual studies with the exception of pneumonia, which was higher with continuous feeding in one study [29] and diarrhea, gastric distension and hyperglycemia, which were seen more frequently in another study [24]
Summary
Enteral nutrition via nasogastric tube in acute stroke patients with dysphagia is an important determinant of patient outcomes. It is unclear whether intermittent or continuous feeding is more efficacious. Dysphagia occurs in up to 50% of patients following a stroke [14] and increases the risk of pneumonia almost ten-fold [5]. NGT bolus feeding was first described by Morrison et al [14] in 1895 for children with Diphtheria, who received 6-ounce bolus feeds 3 times a day via NGT It wasn’t until 1910s when Morgan et al [15] and Jones et al [16] began administering their enteral feeds “drop by drop” rather than as a bolus. The Copyright © All rights are reserved by Giovanni Di Paolo
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