In-hospital Weight Loss Research Articles

In-hospital malnutrition among adult patients in a national referral hospital in Indonesia.

Malnutrition during hospitalization is linked to increased morbidity and mortality, but there are insufficient studies observing clinical factors contributing to weight loss during hospitalization in Indonesia. This study was therefore undertaken to determine the rate of weight loss during hospitalization and the contributing factors. This was a prospective study involving hospitalized adult patients aged 18-59 yrs, conducted between July and September 2019. Body weight measurement was taken at the time of admission and on the last day of hospitalization. The factors studied were malnutrition at admission (body mass index < 18.5 kg/m2), immobilization, depression (Beck Depression Inventory-II Indonesia), polypharmacy, inflammatory status (neutrophil-lymphocytes ratio; NLR), comorbidity status (Charlson Comorbidity Index; CCI), and length of stay. Totally, 55 patients were included in the final analysis, with a median age of 39 (18-59 yrs) yrs. Of these, 27% had malnutrition at admission, 31% had a CCI score > 2, and 26% had an NLR value of ≥ 9. In all, 62% presented with gastrointestinal symptoms, and depression was documented in one-third of the subjects at admission. Overall, we recorded a mean weight loss of 0.41 kg (P = 0.038) during hospitalization, with significant weight loss observed among patients hospitalized for 7 days or more (P = 0.009). The bivariate analysis revealed that inflammatory status (P = 0.016) was associated with in-hospital weight loss, while the multivariate analysis determined that the contributing factors were length of stay (P < 0.001) and depression (P = 0.019). We found that inflammatory status of the patient might influence the incidence of weight loss during hospitalization, while depression and length of stay were independent predictors of weight loss during hospitalization.

Exercise Preferences and Benefits in Patients Hospitalized with COVID-19.

Background: Obese people are at risk of becoming severely ill due to SARS-CoV-2. The exercise benefits on health have been emphasized. Aim: To investigate the correlation of obesity with the length of hospitalization, the pre- and post-hospitalization exercise preferences of COVID-19 patients, and the impact of pre-admission or post-hospitalization physical activity on dyspnea one month after hospitalization and recovery time. Methods: A telephone survey was conducted in patients hospitalized at the Respiratory Medicine Department, University of Thessaly, Greece, from November to December 2020. Results: Two-thirds of the patients were obese. Obesity was not associated with the hospitalization time. Two-thirds of the patients used to engage in physical activity before hospitalization. Males exercised in a higher percentage and more frequently than women before and after hospitalization. The methodical pre-hospitalization exercise was associated with lower levels of dyspnea one month after hospitalization. In-hospital weight loss, comorbidities, and dyspnea on admission independently predicted longer recovery time. Lockdown had boosted men’s desire to exercise than females who were negatively affected. Conclusions: Obesity is common in COVID-19 hospitalized patients. In-hospital weight loss, comorbidities, and dyspnea on admission predicted a longer post-hospitalization recovery time. The pre-hospitalization exercise was associated with less post-hospitalization dyspnea and recovery time.

In-Hospital Weight Loss and Outcomes in Patients With Heart Failure

Acute decompensation of heart failure (HF) is often marked by fluid retention, and weight loss is a marker of successful diuresis. We examined the relationship between in-hospital weight loss and post-discharge outcomes in patients with HF. We conducted a propensity score-matched study of 8830 patients hospitalized for decompensated HF in the Medicare-linked Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF) registry, in which 4415 patients in the weight-loss group and 4415 patients in the no-weight-loss group were balanced on 75 baseline characteristics. We defined weight loss as an admission-to-discharge weight loss of 1-30 kilograms, and we defined no weight loss as a weight gain or loss of < 1 kilogram. Hazard ratios (HRs) and 95% confidence intervals (CIs) for outcomes associated with weight loss were estimated. Patients had a mean age of 78 years, 57% were women, and 11% were African American. The median weight loss in the weight-loss group was 3.6 (interquartile range, 2.0-6.0) kilograms. HRs and 95% CIs for 30-day all-cause mortality, all-cause readmission and HF readmission associated with weight loss were 0.75 (0.63-0.90), 0.90 (0.83-0.99) and 0.83 (0.72-0.96), respectively. Respective 60-day HRs (95% CIs) were 0.80 (0.70-0.92), 0.91 (0.85-0.98) and 0.88 (0.79-0.98). These associations were attenuated and lost significance during 6 months of follow-up. Among older patients hospitalized for decompensated HF, in-hospital weight loss was associated with a lower risk of mortality and hospital readmission. These findings suggest that in-hospital weight loss, a marker of successful diuresis and decongestion, is also a marker of improved clinical outcomes.

Sex Differences in Clinical Course and Patient-Reported Outcomes Among Patients Hospitalized for Heart Failure

ObjectivesThe goal of this study was to evaluate differences in clinical and patient-reported outcomes between women and men hospitalized for acute HF. BackgroundAmong patients hospitalized for heart failure (HF), it is unclear if symptom burden, response to therapy, and patient-reported quality of life (QOL) are different in women as compared with men. MethodsThe ASCEND-HF (Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure) trial randomized 7,141 patients hospitalized for HF with reduced or preserved ejection fraction (EF) to receive nesiritide or placebo in addition to standard care. Clinical endpoints included 30-day mortality and rehospitalization and 180-day mortality. Patient-reported QOL was assessed at baseline, discharge, and 30 days using the EuroQOL 5 dimensions (EQ-5D) survey. ResultsAmong 7,141 total patients, 4,697 (65.8%) were men and 2,444 (34.2%) were women. Among patients with EF ≤40%, women were less likely to receive angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker and beta-blocker therapy, and less likely to have an implantable cardioverter-defibrillator (all p < 0.03). Signs and symptoms of HF were similar between men and women (all p > 0.05), but women experienced less in-hospital weight loss and urine output (all p < 0.01). In unadjusted and adjusted analyses, men and women had similar risk of all mortality and rehospitalization endpoints (all p ≥ 0.41). Women reported lower EQ-5D utility and visual analogue scores at admission, discharge, and 30 days. Women continued to have significantly lower EQ-5D scores at all in-hospital and post-discharge time points after adjustment for clinical characteristics (all p < 0.01). ConclusionsIn this acute HF population, women had similar risk of mortality and rehospitalization as compared with men, but experienced worse patient-reported QOL during and after hospitalization that persisted after adjustment for demographic and clinical factors. Current acute HF management may work similarly in either sex for purposes of preventing clinical events, but may be less equipped to improve patient-reported outcomes in women as compared with men.

Weight change in heart failure inpatients not associated with 30-day readmission.

Background: The association of weight change and short-term readmission in patients hospitalized for heart failure (HF) has not been well studied. Methods: We collected clinical and weight data from patients admitted with decompensated HF to a single center (2012-2013). We performed logistic regression to determine the association between weight change and two outcomes: a total of30-day HF-specific readmission and 30-day all-cause readmission. Results: Admission and discharge weights were documented in 479/658 patients (73%). Weight loss >2kg was not associated with 30-day all-cause or HF-specific readmission when compared with more modest inpatient weight change (-2kg to+2kg;all-cause readmission odds ratio: 0.86; CI: 0.56-1.37; HF-specific readmission odds ratio: 1.15; CI: 0.61-2.16). Conclusion: Among HF inpatients, in-hospital weight loss was not associated with 30-day all-cause or HF-specific readmission.

Three Nurse-administered Protocols Reduce Nutritional Decline and Frailty in Older Gastrointestinal Surgery Patients: A Cluster Randomized Trial

ObjectiveTo evaluate the effects of the modified Hospital Elder Life Program (mHELP) comprising 3 nurse-administered protocols in older patients undergoing gastrointestinal (GI) surgery. DesignCluster randomized trial. SettingTwo 36-bed GI wards at a university-affiliated medical center in Taiwan. ParticipantsOlder patients (≥65 years, N = 377) were recruited if they were scheduled for elective GI surgery with an expected length of hospital stay >6 days. After transferring to the GI ward after surgery, participants were randomly assigned to the mHELP or control group (1:1) by room rather than individually because most patient units are double- or triple-occupancy rooms. InterventionThe mHELP protocols (early mobilization, oral and nutritional assistance, and orienting communication) were administered daily with usual care by a trained nurse until hospital discharge. The control group received usual care only. MeasuresOutcomes were in-hospital nutritional decline, measured by body weight and Mini-Nutritional Assessment (MNA) scores, and Fried's frailty phenotype. Return of GI motility was examined as a potential mechanism contributing to observed outcomes. ResultsParticipants (mean age = 74.5 years; 56.8% male) primarily underwent colorectal (56.5%), gastric (21.2%), and pancreatobiliary (13.8%) surgery. Participants who received the mHELP [for a median of 7 days (interquartile range = 6–10 days)] had significantly lower in-hospital weight loss and decline in MNA scores (weight −2.1 vs −4.0 lb, P = .002; score −3.2 vs −4.0, P = .03) than the control group. The mHELP group also had significantly lower rates of incident frailty during hospitalization (12.0% vs 21.7%, P = .022), and persistent frailty (50.0% vs 92.9%, P = .03). Participants in the mHELP group had trends toward an accelerated return of GI motility. Conclusion and ImplicationsThe mHELP effectively reduced nutritional decline, prevented new frailty, and promoted recovery of frailty present before admission. These nurse-administered protocols might be useful in other settings, including conditions managed at home or in nursing facilities.

Impact of in-hospital birth weight loss on short and medium term breastfeeding outcomes

BackgroundThe definition for lower limit of safe birthweight loss among exclusively breastfed neonates is arbitrary. Despite this, in cases of great in-hospital weight loss, breastfeeding adequacy is immediately questioned. The aim of this study was to examine the relationship between weight loss at discharge from hospital, when babies are ready to go home, and eventual cessation of exclusive breastfeeding since birth.MethodsThis is a secondary analysis of a cohort study. Study participants were 788 full term, breastfed and stable babies, born in 2007–2012 consecutively enrolled to primary care pediatric clinics in Majorca, Spain. Data were collected by chart review. The main predictor was birthweight loss at discharge. Extreme weight loss was defined as the 90th and 95th centiles of birthweight loss for babies who were delivered by vaginal delivery and by cesarean section. Main outcomes were cessation of exclusive breastfeeding by 7, 15, 30 and 100 days of life. Multivariate regression analysis was performed to study the relationship of selected variables with exclusive breastfeeding cessation since birth.ResultsWe observed a median weight loss of 6%. In bivariate analysis, quartiles of birthweight loss at discharge were predictive of exclusive breastfeeding cessation at 15, 30 and 100 days postpartum. In multivariate analysis: in-hospital weight loss above the median did predict exclusive breastfeeding cessation by 15, 30 and 100 days of life, Adjusted Odds Ratios (AORs) (95% Confidence Intervals [CIs]): 1.57 (1.12, 2.19), 1.73 (1.26, 2.38) and 1.69 (1.25, 2.29), respectively. In contrast, we did not find that newborn extreme weight losses were associated with exclusive breastfeeding cessation.ConclusionsWe report that extreme birthweight loss does not trigger immediate formula supplementation. We do not identify any cut-off values to be used as predictors for the initiation of supplementary feeding, this research question remains unanswered.

In-hospital weight loss, prescribed diet and food acceptance.

BackgroundWeight loss and malnutrition may be caused by many factors, including type of disease and treatment.AimThe present study investigated the occurrence of in-hospital weight loss and related factors.MethodThis cross-sectional study investigated the following variables of 456 hospitalized patients: gender, age, disease, weight variation during hospital stay, and type and acceptance of the prescribed diet. Repeated measures analysis of variance (ANOVA) was used for comparing patients' weight in the first three days in hospital stay and determining which factors affect weight. The generalized estimating equation was used for comparing the food acceptance rates. The significance level was set at 5%.ResultsThe most prescribed diet was the regular (28.8%) and 45.5% of the patients lost weight during their stay. Acceptance of hospital food increased from the first to the third days of stay (p=0.0022) but weight loss was still significant (p<0.0001). Age and type of prescribed diet did not affect weight loss during the study period but type of disease and gender did. Patients with neoplasms (p=0.0052) and males (p=0.0002) lost more weight.ConclusionWeight loss during hospital stay was associated only with gender and type of disease.

PP189-SUN: In-Hospital Weight Loss, Prescribed Diet and Food Acceptance

PP189-SUN: In-Hospital Weight Loss, Prescribed Diet and Food Acceptance

Nutritional Status of Children Hospitalized for Parapneumonic Effusion

Background & AimsAmong children hospitalized for pneumonia, those with parapneumonic effusion (PPE) are at particular risk for nutritional deterioration. This study aimed to 1) investigate the evolution of the nutritional status during hospitalization and at outpatient follow-up; 2) determine clinical risk factors for weight loss during hospitalization; 3) describe the nutritional interventions for these children.MethodsRetrospective chart review (January ‘07 - September ‘12) of 56 children with pneumonia, complicated by PPE in two Belgian hospitals for data on body weight and height at admission (t0) and discharge (t1), and two weeks (t2) and one month (t3) after discharge. Length of hospitalization (LoS), length of stay in paediatric intensive care (LoSPICU) and maximal in-hospital weight loss (tmax) were calculated and nutritional interventions were recorded.ResultsThe median (range) age was 3.5 (1.0–14.8) years. Weight or height was lacking in five (8.9%) children at t0 and in 28 (50%) at t1; 21.4% was weighed only once during hospitalization. At tmax, respectively 17/44 and 5/44 children lost ≥5% and ≥10% of their weight. Median (range) LoS and LoSPICU were 18.0 (10–41) and 4.0 (0–23) days. One-fourth received a nutritional intervention. Weight for height at admission (WFH(t0)) significantly predicted maximal weight loss (β (95% CI) = −0.34 (−2.0–−0.1); p = 0.03). At t2 and t3, 13/32 and 5/22 of the children with available follow-up data did not reach WFH(t0), whilst in 4/35 and 5/26 body weight remained ≥5% under the weight(t0).ConclusionsOne-third of children with pneumonia complicated by PPE and monitored for weight and height, lost ≥5% of their body weight during hospitalization. One-fourth did not reach initial WFH one month after discharge. Those with a higher WFH at admission were at higher risk of weight loss. More attention for monitoring of weight loss and the nutritional policy during and after hospitalization is warranted.

The Geriatric Nutritional Risk Index predicts hospital length of stay and in-hospital weight loss in elderly patients

Nutritional derangements are common in elderly patients, but how nutritional risk affects outcome in this subset of hospital inpatients deserves further investigation. We evaluated the impact of nutritional risk on length of stay (LOS) and in-hospital weight loss (WL) in elderly patients (>65 yrs). Nutritional risk was assessed by the Geriatric Nutritional Risk Index (GNRI) in a prospective multicentre hospital-based cohort study. The outcomes were LOS and in-hospital WL. In the whole sample (N = 667), the prevalence of high (GNRI < 92) and mild (GNRI: 92-98) nutritional risk were 33% and 25%, respectively. Patients with a high nutritional risk were more likely (OR = 1.89; 95%CI: 1.22-2.92) to stay longer in hospital (fourth quartile, LOS ≥ 20 days) compared to those without. Other factors associated with prolonged LOS were cancer diagnosis (OR = 2.52; 95%CI: 1.69-3.75), the presence of comorbidities (OR = 1.24; 95%CI: 1.11-1.40) and surgical setting (OR = 1.65; 95%CI: 1.10-2.47). In-hospital WL ≥ 5% was recorded in 75 ambulant patients from a representative subgroup (N = 583). It was independently associated with prolonged LOS (OR = 1.80; 95%CI: 1.03-3.06) and was more frequent among cancer patients (OR = 1.88; 95%CI: 1.09-3.24), in patients with a high nutritional risk (OR = 2.23; 95%CI: 1.20-4.14) or those admitted to surgical units (OR = 1.77; 95%CI: 1.02-3.05). Nutritional risk assessed by the GNRI on admission, predicts LOS and in-hospital WL in elderly patients.

Weight Loss in Exclusively Breastfed Infants Delivered by Cesarean Birth

Rates of exclusive breastfeeding during the postpartum hospital stay are a key measure of quality maternity care. Often, however, concern for excessive in-hospital weight loss leads to formula supplementation of breastfed infants. The American Academy of Pediatrics defines 7% weight loss as acceptable for breastfed newborns regardless of mode of delivery. Typical weight loss in exclusively breastfed infants delivered by cesarean birth has not been studied nor have possible correlates of greater weight loss in this population. To determine average weight loss in a cohort of exclusively breastfed infants delivered by cesarean birth and to identify correlates of greater than expected weight loss. We performed a retrospective chart review of exclusively breastfed infants delivered via cesarean birth at a Baby-Friendly hospital between 2005 and 2007. Average weight loss was calculated, and multivariate regression analysis was performed. Average weight loss during the hospital stay in our cohort of 200 infants was 7.2% ± 2.1% of birth weight, slightly greater than the American Academy of Pediatrics guideline of 7%. Absence of labor prior to delivery was significantly associated with a greater percentage of weight loss (P = .0004), as were lower gestational age (P = .0004) and higher birth weight (P < .0001). Maternal age, gravity, parity, infant sex, Apgar scores, and prior cesarean birth were not significantly associated. We conclude that for exclusively breastfed infants delivered by cesarean birth in a Baby-Friendly hospital, absence of labor prior to cesarean birth may be a previously unreported risk factor for greater than expected weight loss.

Nutritional parameters associated with prolonged hospital stay among ambulatory adult patients.

Comprehensive evaluations of the nutritional parameters associated with length of hospital stay are lacking. We investigated the association between malnutrition and length of hospital stay in a cohort of ambulatory adult patients. From September 2006 to June 2009, we systematically evaluated 1274 ambulatory adult patients admitted to hospital for medical or surgical treatment. We evaluated the associations between malnutrition and prolonged hospital stay (> 17 days [> 75th percentile of distribution]) using multivariable log-linear models adjusted for several potential nutritional and clinical confounders recorded at admission and collected during and at the end of the hospital stay. Nutritional factors associated with a prolonged hospital stay were a Nutritional Risk Index score of less than 97.5 (relative risk [RR] 1.64, 95% confidence interval [CI] 1.31-2.06) and an in-hospital weight loss of 5% or greater (RR 1.60, 95% CI 1.30-1.97). Sensitivity analysis of data for patients discharged alive and who had a length of stay of at least three days (n = 1073) produced similar findings (adjusted RR 1.51, 95% CI 1.20-1.89, for Nutritional Risk Index score < 97.5). A significant association was also found with in-hospital starvation of three or more days (RR 1.14, 95% CI 1.01-1.28). Nutritional risk at admission was strongly associated with a prolonged hospital stay among ambulatory adult patients. Another factor associated with length of stay was worsening nutritional status during the hospital stay, whose cause-effect relationship with length of stay should be clarified in intervention trials. Clinicians need to be aware of the impact of malnutrition and of the potential role of worsening nutritional status in prolonging hospital stay.

First-Day Newborn Weight Loss Predicts In-Hospital Weight Nadir for Breastfeeding Infants

Exclusive breastfeeding reduces infant infectious disease. Losing > or =10% birth weight may lead to formula use. The predictive value of first-day weight loss for subsequent weight loss has not been studied. The objective of the present study was to evaluate the relationship between weight loss at <24 hours and subsequent in-hospital weight loss > or =10%. For 1,049 infants, we extracted gestational age, gender, delivery method, feeding type, and weights from medical records. Weight nadir was defined as the lowest weight recorded during birth hospitalization. We used multivariate logistic regression to assess the effect of first-day weight loss on subsequent in-hospital weight loss. Mean in-hospital weight nadir was 6.0 +/- 2.6%, and mean age at in-hospital weight nadir was 38.7 +/- 18.5 hours. While in the hospital 6.4% of infants lost > or =10% of birth weight. Infants losing > or =4.5% birth weight at <24 hours had greater risk of eventual in-hospital weight loss > or =10% (adjusted odds ratio 3.57 [1.75, 7.28]). In this cohort, 798 (76.1%) infants did not have documented weight gain while in the hospital. Early weight loss predicts higher risk of > or =10% in-hospital weight loss. Infants with high first-day weight loss could be targeted for further research into improved interventions to promote breastfeeding.

Short-term nutritional implications of total gastrectomy for malignancy, and the impact of parenteral nutritional support

To report on peri-operative nutritional status in gastric cancer patients undergoing total gastrectomy, and to examine the role of post-operative parenteral nutrition. Retrospective study of prospectively collected data on 90 consecutive patients who underwent total gastrectomy for malignancy. At diagnosis 46% of patients reported clinically severe weight loss, and dietary intake was inadequate in 72% of patients. Post-operatively 42% were given total parenteral nutrition (TPN) and 53% were given intravenous fluids (IVF) alone. TPN patients spent a mean of 13.6 days on nutrition support versus IVF patients who spent a mean of 9.2 days without any form of nutrition. IVF patients lost significantly more weight in hospital than TPN patients (5.2 kg versus 3.1 kg, p=0.008). 69% of IVF patients lost severe amount of weight versus 34% in the TPN group (p=0.01). Post-discharge, IVF patients continued to lose significantly more weight than those given TPN post-operatively (7.5 kg versus 2.9 kg, p=0.01) corresponding to 10.5% of their body weight from discharge to follow up versus 4.9% for TPN group (p=0.014). From pre-illness to follow up, patients lost an average of 15.5 kg--IVF patients lost 17.8 kg versus 9.6 kg in TPN (p<0.01). There was no difference in post-operative complications between the groups; however, patients with >10% weight loss had a significantly higher rate of complications and a significantly higher mortality rate than patients who lost <10% body weight (26.2% versus 51.9%, p=0.036 and 11.1% versus 0%, p=0.027, respectively). On multivariate logistic regression analysis >10% weight loss at diagnosis was the only predictive factor of post-operative complications OR 3.1 (95% CI 1.0-9.6), p=0.04). There is a high prevalence of malnutrition in gastric cancer patients undergoing surgery. Total gastrectomy is associated with dramatic weight loss, which continues beyond the surgeon's view post-discharge, with patients losing an average of 15.5 kg by 3-month follow up. Provision of nutrition support in the form of TPN post-operatively significantly reduces in-hospital weight loss and also helps to attenuate further weight loss post-discharge.

Factors Associated With Newborn In-Hospital Weight Loss: Comparisons by Feeding Method, Demographics, and Birthing Procedures

Full-term newborn normative weight loss and factors influencing this were determined through chart audits (n = 812) at 6 hospitals in Manitoba, Canada. The effects of parity, gestational age, birth weight, sex, length of stay, type of delivery (cesarean vs vaginal), epidural use, and type of infant feeding (exclusively breastfed, partially breastfed, exclusively formula-fed) on percentage weight loss in hospital were analyzed using multiple regression analysis. In-hospital weight loss was 5.09% +/- 2.89% (95% CI, 4.89-5.29), varying by feeding category: exclusively breastfed 5.49% +/- 2.60% (95% CI, 5.23-5.74), partially breastfed 5.52% +/- 3.02% (95% CI, 5.16-5.88), and formula-fed 2.43% +/- 2.12% (95% CI, 2.02-2.85). Factors significantly increasing the percentage weight loss included higher birth weight, female sex, epidural use, and longer hospital stay. Lower percentage weight loss was associated with greater gestational age and exclusive formula feeding. Parity and type of delivery were not significant. Controlling for demographic and delivery-related variables, exclusive formula feeding had the largest impact, with 3.1% less weight loss than exclusive breastfeeding.

Nasojejunal feeding in hyperemesis gravidarum—a preliminary study

Hyperemesis gravidarum is a severe form of nausea and vomiting during the first trimester of pregnancy. Our objective was to assess the feasibility of nasojejunal feeding in our patients. Eleven pregnant women aged 23–46 years with hyperemesis gravidarum, persisting in spite of an in-hospital treatment of 2–15 days by intravenous fluids and antiemetic drugs and accompanied by weight loss, consented to have a nasojejunal feeding tube inserted endoscopically. Mean in-hospital weight loss prior to tube insertion was 2.2±1.1 kg (range 0.9–5.1 kg). A clear reduction in the extent of vomiting was already apparent within the first 48 h after tube insertion, but vomiting ceased completely after a mean of 5±4 days (range 1–13 days). Weight gain was recorded in six patients who stayed on tube feeding for more than 4 days. Patients were encouraged to start drinking and eating along tube feeding after 3–4 days. Ceasing vomiting and a concomitant sufficient oral intake of at least 1000 kcal/day resulted in the decision to remove the tube after 4–21 days. In three cases, however, the tube was expelled by recurrent vomiting after 1–4 days, or was blocked as in one case. The tube was not reintroduced and patients did not resume vomiting. There were no complications associated with this feeding approach in this population. Only one patient was readmitted. None of the rest resumed vomiting after tube withdrawal. The above suggests that nasojejunal enteral feeding can be an effective option in hyperemesis gravidarum persisting despite intravenous fluids and antiemetic drugs.