Feeding Tube Clinic Effect on Nutrition.

IF 1.1 4区医学 Q3 SURGERY Surgical Laparoscopy, Endoscopy & Percutaneous Techniques Pub Date : 2024-08-01 DOI:10.1097/SLE.0000000000001277

Kevin Choy, Danielle Abbitt, Amber Moyer, John T Moore, Krzysztof J Wikiel, Teresa S Jones, Thomas N Robinson, Edward L Jones

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Abstract

Background: Optimizing nutrition is essential for recovery after major surgery or severe illness. Feeding tubes (FT) can be placed in patients limited by oral enteral nutrition. Given the myriad of locations in which these procedures are performed (radiology, intensive care unit, and endoscopy suite), routine follow-up is challenging. The purpose of this study was to evaluate the impact of an FT clinic on nutrition. We hypothesized that enrollment in the FT clinic would result in improved nutritional outcomes.

Methods: Retrospective review of Veteran Affairs Medical Center patients with FTs placed from January 2010 to January 2020. Demographics and body mass index (BMI) were recorded. Serum albumin recorded within 1 month of tube placement was compared to within 1 month of tube removal, death, or at the end of the study period. FT clinic participation required at least 2 visits. Indications for FT placement and duration were recorded. Patients were excluded when both BMI and albumin values were incomplete, and if FTs were placed for decompression.

Results: Ninety-three patients underwent FT placement during the study period; 5 (5%) were excluded. The average age was 64.8±9.7 years, with the majority being male, 85 patients (97%). Eighteen (20%) patients were seen in the FT clinic (FTC) and 70 (80%) were managed outside of FTC (nFTC). There were no differences in age, gender, or indication for FT. Mean albumin increased 0.42±0.85 g/dL in the FTC group versus -0.07±0.72 g/dL in the nFTC group ( P =0.037). The FTC group BMI increased, 0.38 kg/m 2 vs. -1.48 kg/m 2 in nFTC patients, P =0.041. The FTC patients maintained their tubes longer (36.5 vs. 7.0 mo, P =0.0014).

Conclusions: Patients managed in a dedicated FT clinic experienced an improvement in their serum albumin values and increases in their BMI. In addition, they also maintained their FTs longer. To optimize nutrition and reduce weight loss, patients who require FTs should be enrolled in a dedicated FT clinic.

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喂食管门诊对营养的影响。

背景：优化营养对大手术或重病后的恢复至关重要。对于口服肠内营养有限的患者，可以放置喂食管（FT）。由于进行这些手术的地点繁多（放射科、重症监护室和内窥镜室），因此常规随访具有挑战性。本研究旨在评估 FT 诊所对营养的影响。我们假设，加入 FT 诊所将改善营养状况：方法：回顾性分析退伍军人事务医疗中心在 2010 年 1 月至 2020 年 1 月期间安置 FT 的患者。记录人口统计学和体重指数（BMI）。将置管后 1 个月内记录的血清白蛋白与拔管后 1 个月内、死亡时或研究期结束时记录的血清白蛋白进行比较。FT 诊所的参与至少需要 2 次就诊。记录了放置输液管的指征和持续时间。如果 BMI 和白蛋白值不完整，或因减压而置入 FT 时，患者将被排除在外：研究期间，93 名患者接受了 FT 置入术，其中 5 人（5%）被排除在外。平均年龄为（64.8±9.7）岁，男性患者占多数，共 85 人（97%）。18名患者（20%）在 FT 诊所（FTC）就诊，70 名患者（80%）在 FTC 以外就诊（nFTC）。在年龄、性别和 FT 适应症方面没有差异。FTC 组的平均白蛋白增加了（0.42±0.85）克/分升，而 nFTC 组的平均白蛋白增加了（-0.07±0.72）克/分升（P=0.037）。FTC 组患者的体重指数增加了 0.38 kg/m2，而 nFTC 组患者的体重指数为-1.48 kg/m2，P=0.041。FTC患者保留输卵管的时间更长（36.5个月 vs. 7.0个月，P=0.0014）：结论：在专门的输血治疗诊所接受治疗的患者，其血清白蛋白值有所改善，体重指数（BMI）也有所提高。此外，他们的全脂奶粉维持时间也更长。为了优化营养和减少体重减轻，需要进行体外受精的患者应到专门的体外受精诊所就诊。

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来源期刊

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques 医学-外科

CiteScore

2.00

自引率

10.00%

发文量

103

审稿时长

3-8 weeks

期刊介绍： Surgical Laparoscopy Endoscopy & Percutaneous Techniques is a primary source for peer-reviewed, original articles on the newest techniques and applications in operative laparoscopy and endoscopy. Its Editorial Board includes many of the surgeons who pioneered the use of these revolutionary techniques. The journal provides complete, timely, accurate, practical coverage of laparoscopic and endoscopic techniques and procedures; current clinical and basic science research; preoperative and postoperative patient management; complications in laparoscopic and endoscopic surgery; and new developments in instrumentation and technology.