Equal aspiration rates from postpylorus and intragastric-placed small-bore nasoenteric feeding tubes: a randomized, prospective study.
Postpylorus delivery of enteral feeding is perceived by many experts to be safer than intragastric delivery. To test this assumption, patients with similar Glasgow Coma Scores were given identical enteral formulas continuously via a 10-French nasoenteric tube, placed into the stomach or beyond the second portion of the duodenum. Observations were made for attainment of desired nutrition, bowel changes, and clinical signs of aspiration. Radiographs of the chest and abdomen were obtained every 3 days. If a tube migrated out of a chosen location, it was replaced. Thirty-three patients were studied. Seventeen patients were fed into the stomach and 16 patients were fed postpylorus. The mean duration of enteral feeding was 11.8 days for the gastric group and 10.9 days for the postpylorus group (p = NS). The time to deliver the desired kilocalories was 3.33 and 2.77 days (p = NS) for gastric and postpylorus-fed patients. Tubes displaced similarly in each group, gastric 0.647, postpylorus 0.750 per duration of feeding (p = NS). Chest radiographs met the criteria for aspiration pneumonia in 31.3% of gastric and 40% of postpylorus-fed patients (p = NS). Together, these data indicate that complications from enterally fed patients are equally common whether the distal port of the feeding tube is in the stomach or beyond the second portion of the duodenum.
Strong
R M
RM
Department of Medicine and Gastroenterology, Loma Linda University Medical Center, California.
Condon
S C
SC
Solinger
M R
MR
Namihas
B N
BN
Ito-Wong
L A
LA
Leuty
J E
JE
D002149:Energy Intake; D004750:Enteral Nutrition / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009748:Nutrition Disorders / Q000628:therapy; D011015:Pneumonia, Aspiration / Q000000981:diagnostic imaging / Q000209:etiology*; D011446:Prospective Studies; D011708:Pylorus; D011859:Radiography; D011897:Random Allocation; D013270:Stomach