Nasogastric Tube Feeding Group Research Articles

Effect of Intermittent Oro-Esophageal Tube Feeding in Bulbar Palsy After Ischemic Stroke: A Randomized Controlled Study.

Nasogastric tube feeding (NG) has been widely used in patients with bulbar palsy after ischemic stroke but is associated with a significant risk of complications including malnutrition and pneumonia. Intermittent oro-esophageal tube feeding (IOE) can help alleviate these concerns. This study explored the clinical effect of IOE versus NG on nutritional status, swallowing function, stroke-associated pneumonia, and depression in patients with bulbar palsy after ischemic stroke. This randomized controlled study included 148 patients with bulbar palsy after ischemic stroke who underwent routine treatment and swallowing rehabilitation training in the Department of Rehabilitation Medicine between July 2017 and July 2019 in China. The participants were randomly divided into the IOE group (n=74) and NG group (n=74) with IOE and NG as nutritional supports, respectively. The primary outcome was nutritional status including (1) body mass index (kg/m2), (2) serum ALB (albumin, g/L), and (3) PA (prealbumin, mg/L). The secondary outcomes were (1) swallowing function including (i) Functional Oral Intake Scale (FOIS) and (ii) Penetration-Aspiration Scale, (2) pneumonia, (3) depression, and (4) adverse events. Statistical analyses for continuous outcomes were performed using t test, Mann-Whitney U test and Wilcoxon signed-rank test and categorical variables using χ2 test. SPSS 21.0 was used for all analysis. There were no significant baseline differences between the 2 groups. After the treatment, the IOE group demonstrated significantly better results compared with the NG group in ALB ([32.71±0.94] versus [32.28±0.81] g/L; P=0.003), PA ([278.15±13.81] versus [270.31±15.08] mg/L; P=0.001], body mass index ([19.77±1.03] versus [19.41±0.98] kg/m2; P=0.002], FOIS (P<0.001), Penetration-Aspiration Scale (P<0.001), stroke-associated pneumonia ([1, 4.05%] versus [26, 35.14%]; P<0.001), depression ([1, 1.35%] versus [44, 59.46%]; P<0.001) and overall less adverse events (reflux, fever, discomfort in the throat; P<0.001). In patients with dysphagia with bulbar palsy after ischemic stroke who received routine treatment and swallowing rehabilitation training, IOE is safer and more conducive to the improvement of nutritional status, swallowing function, stroke-associated pneumonia, and depression than NG. URL: https://www.chictr.org.cn; Unique identifier: ChiCTR-INC-17011741.

Comparison of nutritional effectiveness and complication rate between early nasojejunal and nasogastric tube feeding in patients with an intracerebral hemorrhage

BackgroundThis study aimed to compare nutritional effectiveness and complication rate between early nasojejunal and nasogastric tube feeding in patients with an intracerebral hemorrhage. MethodsThis was a retrospective study. Eighty patients with an intracerebral hemorrhage were divided into a nasojejunal and a nasogastric tube feeding group. Feeding tubes were placed within 6 h after admission, and enteral feeding began within 2 h after tube placement. The nutritional status and complication rate of the 2 groups were compared before and 2 and 4 weeks after beginning feeding. ResultsSerum prealbumin, serum albumin, and hemoglobin levels were significantly higher in the nasojejunal tube feeding group than in the nasogastric tube feeding group at 2 and 4 weeks after beginning feeding (all, p < 0.05). The incidence of gastric retention, pulmonary aspiration, and pneumonia were lower in the early nasojejunal tube feeding group than in the early nasogastric tube feeding group (all, p < 0.05). There was no significant difference in the incidence of diarrhea between the 2 groups. ConclusionCompared with early nasogastric feeding, early nasojejunal feeding provides better nutritional effectiveness and a lower incidence of gastric retention, pulmonary aspiration, and pneumonia in patients with an intracerebral hemorrhage.

Nasogastric or nasojejunal feeding in pediatric acute pancreatitis: a randomized controlled trial

The aim of this study was to compare nasogastric (NG) feeding with nasojejunal (NJ) feeding when treating pediatric patients with acute pancreatitis (AP). We performed a single-center, prospective, randomized, active-controlled trial involving 77 pediatric patients with AP from April 2014 to December 2017. The patients were randomized into two groups: the NG tube feeding group (34 patients) and the NJ tube feeding group (33 patients). The primary outcome measures included the enteral nutrition intolerance, the length of tube feeding time, the recurrent pain of pancreatitis and complications. A total of 62 patients with AP (31 patients for each group) came into the final analysis. No differences were found in baseline characteristics, pediatric AP score and computed tomography severity score between the two groups. Three (9.7%) patients in the NG group and one (3.2%) patient in the NJ group developed intolerance (relative risk = 3.00, 95% confidence interval 0.33-27.29, P = 0.612). The tube feeding time and length of hospital stay of the NG group were significantly shorter than those of the NJ group (P = 0.016 and 0.027, respectively). No patient died in the trial. No significant differences were found in recurrent pain, complications, nutrition delivery efficacy, and side effects between the two groups. NG tube feeding appears to be effective and safe for acute pediatric pancreatitis compared with NJ tube feeding. In addition, high qualified, large sample sized, randomized controlled trials in pediatric population are needed.

Percutaneous Endoscopic Gastrostomy and Nutritional Interventions by the Pediatric Nutritional Support Team Improve the Nutritional Status of Neurologically Impaired Children.

Aim: To evaluate the long-term effects of nutritional improvement following percutaneous endoscopic gastrostomy (PEG) tube feeding stratified by previous feeding method and to assess the impact of underlying muscle tone on the outcomes of the nutritional intervention. Methods: Neurologically impaired children who underwent PEG tube insertion and nutritional intervention provided by a pediatric nutritional support team were enrolled. We measured anthropometric variables, laboratory parameters, and nutritional intake at baseline, 6 months after PEG insertion, and the last visit. We evaluated the percent ideal body weight (PIBW), body mass index (BMI)-for-age z-score, and percentiles and calculated the ratios of calorie intake compared to required requirement (CIR) and protein intake compared to recommended requirement (PIR). Results: The PIBW and BMI-for-age z-score improved during the first 6 months (p = 0.003 and p = 0.005, respectively). The CIR (p = 0.015) and PIR (p = 0.004) increased during the study period. The baseline BMI and PIBW of the previous nasogastric tube feeding group were better than those of the oral feeding group (p = 0.02 and p = 0.03, respectively). The BMI-for-age z-score, PIBW, CIR, and PIR improved in the hypertonic group (p = 0.03, 0.02, 0.03, and 0.01, respectively). Conclusion: PEG tube feeding and active nutritional intervention improved the nutritional status of neurologically impaired children immediately after PEG insertion. The nutritional requirements might vary by the muscle tonicity.

Nasogastric tube feeding versus assisted hand feeding in-home healthcare older adults with severe dementia in Taiwan: a prognosis comparison

BackgroundAll individuals with severe dementia should be offered careful hand feeding. However, under certain circumstances, people with severe dementia have a feeding tube placed. In Taiwan, tube feeding rate in demented older home care residents is increasing; however, the benefits of tube feeding in this population remain unknown. We compared the clinical prognosis and mortality of older patients with severe dementia receiving nasogastric tube feeding (NGF) or assisted hand feeding (AHF).MethodsData from the in-home healthcare system between January 1 and December 31, 2017 were analyzed to identify 169 participants over 60 years of age in this retrospective longitudinal study. All subjects with severe dementia and complete functional dependence suffered from difficulty in oral intake and required either AHF or NGF. Data were collected from both groups to analyze pneumonia, hospitalization, and mortality rates.ResultsA total of 169 subjects (56 males and 113 females, aged 85.9 ± 7.5 years) were analyzed. 39 required AHF and 130 NGF. All subjects were bedridden; 129 (76%) showed Barthel index < 10. Pneumonia risk was higher in the NGF group (48%) than in the AHF group (26%, p = 0.015). After adjusting for multiple factors in the regression model, the risk of pneumonia was not significantly higher in the NGF group compared with the AHF group. One-year mortality rates in the AHF and NGF groups were 8 and 15%, respectively, and no significant difference was observed after adjustment with logistic regression (aOR = 2.38; 95% CI, 0.58–9.70). There were no significant differences in hospitalization rate and duration.ConclusionsFor older patients with dementia requiring in-home healthcare, NGF is not associated with a significantly lower risk of pneumonia than AHF. Additionally, neither mortality nor hospitalization rates decreased with NGF. On the contrary, a nonsignificant trend of increased risk of pneumonia was observed in NGF group. Therefore, the benefits of NGF are debatable in older patients with severe dementia requiring in-home healthcare. Continued careful hand feeding could be an alternative to NG feeding in patients with severe dementia. Furthermore, large-scale studies on in-home healthcare would be required to support these results.

Effects of different feeding methods on Ghrelin and growth and development of premature infants

Objective To compare the effects of different feeding methods on plasma Ghrelin (a peptide hormone) level, growth and development of premature infants. Methods A total of 147 cases of very low birth weight newborn were randomly divided into nasogastric tube feeding group (group A, 38 cases) , nasogastric tube feeding combined with non-nutritional sucking group (group B, 39 cases) , nasogastric tube feeding combined with infantile touching group (group C, 34 cases) , nasogastric tube feeding combined with non-nutritional sucking and infantile touching group (group D, 36 cases) . Anthropometric indicators and plasma Ghrelin levels of premature infants before and after the feeding were compared among four groups. Results At 2 weeks post admission, the body weight of premature infants in four groups were (1 503±206) g (group A) , (1 487±211) g (group B) , (1 494±228) g (group C) , and (1 615±242) g (group D) . The differences between group D and other groups were statistically significant (t=2.004, 2.262, 2.061; P<0.05) . At 4 weeks post admission, the plasma Ghrelin levels of premature infants in four groups were (38.3±7.4) μg/L (group A) , (39.3±6.9) μg/L (group B) , (35.7±6.6) μg/L (group C) , and (34.5±9.1) μg/L (group D) . The increases of plasma Ghrelin levels between group A and group C or D were statistically significant (t=2.65, 5.20; P<0.05) . Similar results were also observed between group B and group C or D (t=3.01, 5.79; P<0.05) . Conclusions Nasogastric tube feeding combined with non-nutritional sucking and infantile touching is efficient in improving quality of life of very low birth weight newborns and saving medical cost. Key words: Very low birth weight premature infants; Tube feeding; Non-nutritive sucking; Touch

Complications related with postoperative enteral nutrition in patients with massive cerebellar infarction

Objective To investigate the complications of different enteral nutrition in patients after surgery for massive cerebellar infarction, so as to guide rational application of enteral nutrition in patients. Methods Forty-nine patients with massive cerebellar infarction were divided into three groups randomly: conventional nasogastric tube feeding group (group A, n=12), nasogastric tube feeding plus gastric motor drug group (group B, n=18), and nasojejunal tube feeding group (group C, n=19). The incidences of diarrhea, reflux, aspiration, upper gastrointestinal bleeding and aspiration pneumonia within 3 weeks after initiation of enteral nutrition were observed and compared among the groups. Results The incidence of diarrhea showed no statistically significant difference among the 3 groups(χ2=0.092, P=0.955). Compared with group A, the incidences of reflux, aspiration and aspiration pneumonia were significantly lower in group B and group C (P<0.05), and lower in group C compared with group B(P<0.05). Compared with group C, the incidence of upper gastrointestinal bleeding was significantly lower in group C than in group A and group B(χ22=4.748, P2=0.029; χ32=4.284, P3=0.038), but the difference between group A and group B was not significant(χ12=0.000, P1=1.000). Conclusions Because of the unique pathophysiological features in patients after surgery for massive cerebellar infarction, early enteral nutrition by conventional nasogastric tube feeding may be inappropriate. Nasogastric tube feeding plus gastric motor drug may be applied in mild case with short course of disease. Nasojejunal tube feeding may be the approach of choice for enteral nutrition in critical patients with massive cerebellar infarction for its association with lower incidence of complications. Key words: Cerebellar infarction; Enteral nutrition; Complication; Nasogastric tube; Nasojejunal tube

Comparative Study Between Nasogastric (Ryle) Feeding and Oral Feeding Post- Cleft Palate Repair

Background: feeding after surgical correction of cleft palate is an important topic; the method of feeding usually affects the surgery outcome and stress of operation in infants. However, no consensus on the method of feeding for children with cleft palate either pre-or post-operative correction. Aim of the work: to investigate the effect of nasogastric tube (NGT) feeding compared with oral feeding on children in the first 48 hours after primary cleft palate repair. Patients and methods: The study was carried out at Al-Azhar University Hospital (Pediatric Surgery Unit);Damietta and specialized kids hospital during the period from January 2015 to Jun 2016. It included 36 children presented for primary repair of cleft palate. All were undergoing full history taking, clinical examination and laboratory investigations to prepare them for surgical intervention. Those patients were divided into 2 equal groups, each group had 18 patients.Then, after intervention, they followed up to examine the effect of method of feeding either by (NGT) (group 1) or oral route (group 2) on the outcome of surgery and postoperative analgesia requirements. Results: both groups were comparable asregard to demographic characteristics, amount of intraoperative fluids and required analgesia and for postoperative surgical outcome and complications. However, there was statistically significant decrease of Postoperative morphine, paracetamol and Ibuprofen in NG feeding group when compared to oral feeding group (0.13±0.08, 32.50±15.55, 14.44±8.72 vs 0.23±0.13, 51.66±28.43, and 26.38±14.43 respectively). Also, there was significant decrease of number of pain episodes in NGT feeding group when compared to oral feeding group (3.17±2.03 vs 4.77±2.86). On the other hand, there was statistically significant increase of the amount of postoperative feeding in NGT feeding when compared to oral feeding group (137.22±13.52 vs 59.72±18.74). Finally, the total duration of hospital stay was significantly shortened in NGT feeding group when compared to oral feeding group (47.55±15.33 vs 78.66±18.04 hours).Conclusion: NGT feeding is effective when compared to oral feeding post-palatoplasty as it increases consumption of foods and reduce postoperative analgesia requirements.

Comparison of Continuous and Intermittent Feeding Methods in Low Birth Weight Infants

Objective About 1 % of infants are of very low birth weight. However, they comprise about 50% of infant mortality. We compare the effects of continuous versus intermittent feeding on physical growth, gastrointestinal tolerance and macronutrient retention in low birth weight infants (Methods A prospective randomized trial clinical trial was performed from 2004-2005. Very low birth weight neonates (n=73) stratified by birth weight were randomly assigned to either the continuous (24- hour) pump group (n=37) or intermittent (every 2 hours) nasogastric tube feeding group (n=35). Weight was measured and recorded on the 3rd , 7th , 10th ,13th ,16th ,19th ,22nd day and at discharge. Data was analyzed via SPSS software, t-student and chi-square tests. Results There were no significant differences in birth weight, gestational age, first feeding age and weight at beginning study. Of the 73 neonates, 61 neonates were discharged from hospital, 11 neonates died and one of them dropped out of the study because of early discharge. There were no significant differences in weight gaining, feeding tolerance, discharge weight (p=0.33) or severity of respiratory distress between the groups. Conclusion This study showed that there were no differences in infant growth relative to the type of feeding.