Nasogastric tube versus postpyloric tube feeding for critical illness: A systematic review and meta-analysis.

IF 1.3 4区 医学 Q4 NUTRITION & DIETETICS Asia Pacific journal of clinical nutrition Pub Date : 2024-09-01 DOI:10.6133/apjcn.202409_33(3).0001
Liru Li, Jie Huang
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Abstract

Background and objectives: Gastric tube feeding and postpyloric tube feeding are two common forms of enteral nutrition in critically ill patients. This study aimed to compare the efficacy and safety of gastric tube feeding with that of postpyloric tube feeding in critically ill patients.

Methods and study design: PubMed, Embase, and Cochrane Library were systematically searched for eligible trials from their inception until March 2023. Relative risks (RRs) or weighted mean differences (WMDs) with 95% confidence intervals (CIs) were used to estimate categorical and continuous outcomes using the random-effects model.

Results: Sixteen trials involving 1,329 critically ill patients were selected for the final meta-analysis. Overall, we noted that gastric tube feeding showed no significant difference from post-pyloric tube feeding in mortality (p = 0.891), whereas the risk of pneumonia was significantly increased in patients who received gastric tube feeding (RR: 1.45; p = 0.021). Furthermore, we noted that gastric tube feeding was associated with a shorter time required to start feeding (WMD: -11.05; p = 0.007).

Conclusions: This research revealed that initiating feeding through the gastric tube required less time compared to postpyloric tube feeding. However, it was also associated with a heightened risk of pneumonia among critically ill patients.

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危重症患者鼻胃管喂养与后胃管喂养的比较:系统回顾和荟萃分析。
背景和目的:胃管喂养和舌后管喂养是危重病人两种常见的肠内营养方式。本研究旨在比较在危重病人中使用胃管喂养与使用后置胃管喂养的有效性和安全性:系统检索了 PubMed、Embase 和 Cochrane 图书馆中从开始到 2023 年 3 月的符合条件的试验。采用随机效应模型,以相对风险(RRs)或加权平均差(WMDs)及95%置信区间(CIs)来估计分类和连续结果:最终的荟萃分析选取了涉及 1329 名重症患者的 16 项试验。总体而言,我们注意到胃管喂养与幽门后胃管喂养在死亡率方面没有显著差异(p = 0.891),而接受胃管喂养的患者患肺炎的风险显著增加(RR:1.45;p = 0.021)。此外,我们还注意到胃管喂养与开始喂养所需时间较短有关(WMD:-11.05;p = 0.007):这项研究表明,通过胃管开始喂食所需的时间比通过幽门后管开始喂食所需的时间短。结论:这项研究表明,通过胃管开始喂食比通过后胃管喂食所需的时间更短,但这也与危重病人患肺炎的风险增加有关。
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来源期刊
CiteScore
2.50
自引率
7.70%
发文量
58
审稿时长
6-12 weeks
期刊介绍: The aims of the Asia Pacific Journal of Clinical Nutrition (APJCN) are to publish high quality clinical nutrition relevant research findings which can build the capacity of clinical nutritionists in the region and enhance the practice of human nutrition and related disciplines for health promotion and disease prevention. APJCN will publish original research reports, reviews, short communications and case reports. News, book reviews and other items will also be included. The acceptance criteria for all papers are the quality and originality of the research and its significance to our readership. Except where otherwise stated, manuscripts are peer-reviewed by at least two anonymous reviewers and the Editor. The Editorial Board reserves the right to refuse any material for publication and advises that authors should retain copies of submitted manuscripts and correspondence as material cannot be returned. Final acceptance or rejection rests with the Editorial Board
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