Equal aspiration rates from postpylorus and intragastric-placed small-bore nasoenteric feeding tubes: a randomized, prospective study
Postpylorus delivery of enteral feeding is perceived by many experts to be safer than intragastric delivery. To test this assumption, patients with similar Glasgow Coma Scores were given identical enteral formulas continuously via a 10-French nasoenteric tube, placed into the stomach or beyond the second portion of the duodenum. Observations were made for attainment of desired nutrition, bowel changes, and clinical signs of aspiration. Radiographs of the chest and abdomen were obtained every 3 days. If a tube migrated out of a chosen location, it was replaced. Thirty-three patients were studied. Seventeen patients were fed into the stomach and 16 patients were fed postpylorus. The mean duration of enteral feeding was 11.8 days for the gastric group and 10.9 days for the postpylorus group (p = NS). The time to deliver the desired kilocalories was 3.33 and 2.77 days (p = NS) for gastric and postpylorus-fed patients. Tubes displaced similarly in each group, gastric 0.647, postpylorus 0.750 per duration of feeding (p = NS). Chest radiographs met the criteria for aspiration pneumonia in 31.3% of gastric and 40% of postpylorus-fed patients (p = NS). Together, these data indicate that complications from enterally fed patients are equa...Continue Reading
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Guideline for prevention of nosocomial pneumonia. The Hospital Infection Control Practices Advisory Committee, Centers for Disease Control and Prevention
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Effect of immediate enteral feeding on trauma patients with an open abdomen: protection from nosocomial infections
Australian and New Zealand Society for Geriatric Medicine. Position statement - dysphagia and aspiration in older people*
Royal College of Physicians Intercollegiate Stroke Working Party evidence-based guidelines for the nutritional support of patients who have had a stroke
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The evolving role of post-ligament of Trietz nasojejunal feeding in enteral nutrition and the need for improved feeding tube design and placement methods
Prospective cohort study comparing the effects of different artificial nutrition methods on long-term survival in the elderly: Japan Assessment Study on Procedures and Outcomes of Artificial Nutrition (JAPOAN)
Comparison of four bedside indicators used to predict duodenal feeding tube placement with radiography
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Effect of postpyloric feeding on gastroesophageal regurgitation and pulmonary microaspiration: results of a randomized controlled trial
The incidence of ventilator-associated pneumonia and success in nutrient delivery with gastric versus small intestinal feeding: a randomized clinical trial
Gastric emptying in critically ill patients is accelerated by adding cisapride to a standard enteral feeding protocol: results of a prospective, randomized, controlled trial
Gastric versus small-bowel tube feeding in the intensive care unit: a prospective comparison of efficacy
Transpyloric passage of feeding tubes in patients with head injuries does not decrease complications
Post-pyloric versus gastric tube feeding for preventing pneumonia and improving nutritional outcomes in critically ill adults
Aspiration pneumonia and pneumonitis: a spectrum of infectious/noninfectious diseases affecting the lung
Percutaneous Endoscopic Gastrostomy After Cardiothoracic Surgery in Children Less Than 2 Months Old: An Assessment of Long-Term Malnutrition Status and Gastrostomy Outcomes
Total enteral nutrition versus total parenteral nutrition during pediatric extracorporeal membrane oxygenation
Multicenter, prospective, randomized, single-blind study comparing the efficacy and gastrointestinal complications of early jejunal feeding with early gastric feeding in critically ill patients
Detection of pepsin and glucose in tracheal secretions as indicators of aspiration in mechanically ventilated children
Incidence and risk factors for oropharyngeal aspiration in mechanically ventilated infants and children
Intravenous erythromycin facilitates bedside placement of postpyloric feeding tubes in critically ill adults: a double-blind, randomized, placebo-controlled study
Synergy between acid and endotoxin in an experimental model of aspiration-related lung injury progression
Percutaneous Endoscopic Gastrostomy Enhances Interstage Growth in Infants With Hypoplastic Left Heart Syndrome.
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