title: Jejunostomy tube feedings should not be stopped in the perioperative patient.
abstract: BACKGROUND
  Anesthetic standard of care is to restrict oral intake for 8 hours before elective surgery. There is no research addressing appropriate preoperative discontinuation of jejunostomy tube (J-tube) feedings. We hypothesized that patients could be fed safely, via a J-tube, until the time of surgery.
  
  
  METHODS
  Patients admitted to a Level I Trauma Center, having J-tubes and undergoing a nonabdominal operation, were prospectively evaluated. Group I patients received J-tube feedings until transport to the operating room. Group II patients had tube feedings discontinued for at least 8 hours before surgery. Data were compared using the Student's t test and contingency table analysis.
  
  
  RESULTS
  There were 46 patients in group I and 36 in group II. There was no incidence of aspiration. Patient groups did not differ in age, mortality, length of stay, injury severity score, or ventilator days. Group I patients had tube feedings discontinued for fewer hours before and after surgery than group II patients (before surgery: 1.40 +/- 1.20 vs 11.61 +/- 5.01, respectively; p < .001; after surgery: 2.99 +/- 7.49 vs 7.11 +/- 9.03, respectively; p = .043); received more kilocalories/ grams of protein on the day of surgery (group I vs group II, 1676.15/89.57 +/- 1133.21/38.04 vs 791.14/57.58 +/-498.66/79.87, respectively; p = .001/p = .032) and more kilocalories/grams of protein on the first postoperative day (group I vs group II, 1580.74/92.57 +/- 600.53/37.96 vs 1152.47/63.53 +/- 733.96/39.40, respectively; p = .006/p = .001).
  
  
  CONCLUSIONS
  Patients receiving J-tubes who are undergoing nonabdominal operations may safely continue enteral nutrition at maximum protein and caloric intake until surgery.
authors.affiliation: Department of Surgery, Kansas University Medical Center, Kansas City 66160-7308, USA.
authors.forename: M
authors.initials: M
authors.lastname: Moncure
authors.forename: E
authors.initials: E
authors.lastname: Samaha
authors.forename: K
authors.initials: K
authors.lastname: Moncure
authors.forename: J
authors.initials: J
authors.lastname: Mitchell
authors.forename: C
authors.initials: C
authors.lastname: Rehm
authors.forename: D
authors.initials: D
authors.lastname: Cypel
authors.forename: J
authors.initials: J
authors.lastname: Eydelman
authors.forename: S E
authors.initials: SE
authors.lastname: Ross
mesh_terms: D000328:Adult; D000368:Aged; D004750:Enteral Nutrition; D006801:Humans; D007582:Jejunostomy; D007902:Length of Stay; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies