当前位置： SCI文献检索 > CRITICAL CARE MEDICINE期刊下所有文献 > Randomized comparison of nasojejunal and nasogastric feeding in critically ill patients.

Randomized comparison of nasojejunal and nasogastric feeding in critically ill patients.

Abstract：

OBJECTIVE:Critically ill patients often develop large gastric residual volumes during nasogastric feeding as a result of poor gastroduodenal motility. Nasojejunal feeding may decrease the severity of this complication. The aim of this study was to determine whether nasojejunal feeding improved tolerance of enteral nutrition by reducing gastric residual volumes. DESIGN:Randomized, prospective, clinical study. SETTING:Intensive care unit of a university-affiliated hospital. PATIENTS:Seventy-three intensive care unit patients expected to require nutritional support for at least 3 days. INTERVENTIONS:Patients were randomized to receive enteral nutrition via a nasojejunal tube (placed endoscopically) (34 patients) or a nasogastric tube (39 patients). A strict protocol was followed, which included regular gastric residual volume measurement (in both groups), the use of predetermined criteria for intolerance, and an attempt at nasojejunal feeding for those nasogastrically fed patients who were intolerant of enteral nutrition. MEASUREMENTS AND MAIN RESULTS:Endoscopic placement of nasojejunal tubes was successful in 98% with no complications of insertion. Patients fed via a nasojejunal tube had 1) a reduced total gastric residual volume in both the first 24 (197 vs. 491 mL, p = .02) and 48 hrs (517 vs. 975 mL, p = .02); 2) a reduced incidence of a single gastric residual volume >150 mL (32% vs. 74%, p = .001); and 3) a trend toward a reduced incidence of intolerance of enteral nutrition (13% vs. 31%, p = .09). Only 13% of those nasogastrically fed patients who were initially intolerant of enteral nutrition remained intolerant once fed via a nasojejunal tube, and only 1.4% of all patients met criteria for commencement of parenteral nutrition. CONCLUSIONS:Enteral nutrition delivered via a nasojejunal tube is associated with a significant reduction in gastric residual volume, a strong trend toward improved tolerance of enteral nutrition, and an extremely low requirement for parenteral nutrition.

journal_name

Crit Care Med

journal_title

Critical care medicine

authors

Davies AR,Froomes PR,French CJ,Bellomo R,Gutteridge GA,Nyulasi I,Walker R,Sewell RB

doi

10.1097/00003246-200203000-00016

subject

Has Abstract

pub_date

2002-03-01 00:00:00

pages

586-90

issue

eissn

0090-3493

issn

1530-0293

journal_volume

pub_type

临床试验,杂志文章,随机对照试验

在线工具

Randomized comparison of nasojejunal and nasogastric feeding in critically ill patients.