BACKGROUND:nasogastric tube (NGT) feeding is commonly used after stroke, but its effectiveness is limited by frequent dislodgement. OBJECTIVE: the objective of the study was to evaluate looped NGT feeding in acute stroke patients with dysphagia. METHODS: this was a randomised controlled trial of 104 patients with acute stroke fed by NGT in three UK stroke units. NGT was secured using either a nasal loop (n = 51) or a conventional adhesive dressing (n = 53). The main outcome measure was the proportion of prescribed feed and fluids delivered via NGT in 2 weeks post-randomisation. Secondary outcomes were frequency of NGT insertions, treatment failure, tolerability, adverse events and costs at 2 weeks; mortality; length of hospital stay; residential status; and Barthel Index at 3 months. RESULTS: participants assigned to looped NGT feeding received a mean 17% (95% confidence interval 5-28%) more volume of feed and fluids, required fewer NGTs (median 1 vs 4), and had fewer electrolyte abnormalities than controls. There was more minor nasal trauma in the loop group. There were no differences in outcomes at 3 months. Looped NGT feeding cost 88 pounds sterling more per patient over 2 weeks than controls. CONCLUSION:looped NGT feeding improves delivery of feed and fluids and reduces NGT reinsertion with little additional cost.
RCT Entities:
BACKGROUND: nasogastric tube (NGT) feeding is commonly used after stroke, but its effectiveness is limited by frequent dislodgement. OBJECTIVE: the objective of the study was to evaluate looped NGT feeding in acute strokepatients with dysphagia. METHODS: this was a randomised controlled trial of 104 patients with acute stroke fed by NGT in three UK stroke units. NGT was secured using either a nasal loop (n = 51) or a conventional adhesive dressing (n = 53). The main outcome measure was the proportion of prescribed feed and fluids delivered via NGT in 2 weeks post-randomisation. Secondary outcomes were frequency of NGT insertions, treatment failure, tolerability, adverse events and costs at 2 weeks; mortality; length of hospital stay; residential status; and Barthel Index at 3 months. RESULTS:participants assigned to looped NGT feeding received a mean 17% (95% confidence interval 5-28%) more volume of feed and fluids, required fewer NGTs (median 1 vs 4), and had fewer electrolyte abnormalities than controls. There was more minor nasal trauma in the loop group. There were no differences in outcomes at 3 months. Looped NGT feeding cost 88 pounds sterling more per patient over 2 weeks than controls. CONCLUSION: looped NGT feeding improves delivery of feed and fluids and reduces NGT reinsertion with little additional cost.
Authors: Claudio A R Gomes; Régis B Andriolo; Cathy Bennett; Suzana A S Lustosa; Delcio Matos; Daniel R Waisberg; Jaques Waisberg Journal: Cochrane Database Syst Rev Date: 2015-05-22
Authors: So Jung Mun; Hyun Sun Jeon; Eun Sil Choi; Ree Lee; Sung Hoon Kim; Sun Young Han Journal: Medicine (Baltimore) Date: 2021-08-13 Impact factor: 1.817