Does looped nasogastric tube feeding improve nutritional delivery for patients with dysphagia after acute stroke? A randomised controlled trial.

Abstract:

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.

journal_name

Age Ageing

journal_title

Age and ageing

authors

Beavan J,Conroy SP,Harwood R,Gladman JR,Leonardi-Bee J,Sach T,Bowling T,Sunman W,Gaynor C

doi

10.1093/ageing/afq088

subject

Has Abstract

pub_date

2010-09-01 00:00:00

pages

624-30

issue

5

eissn

0002-0729

issn

1468-2834

pii

afq088

journal_volume

39

pub_type

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