Journal article
Effect of Rotational Therapy on Aspiration Risk of Enteral Feeds
Nutrition in clinical practice, Vol.27(6), pp.808-811
12/2012
DOI: 10.1177/0884533612462897
PMID: 23087262
Abstract
Background: Enteral nutrition has been demonstrated to reduce ventilator days and the incidence of pneumonia, but the safest route for providing enteral nutrition to mechanically ventilated patients is unclear. Our objective was to determine if there is a difference between the incidences of microaspiration of gastric secretions in patients fed via a nasogastric tube vs a postpyloric tube while undergoing rotational therapy for acute respiratory distress syndrome (ARDS). Materials and Methods: Institutional review board approval was obtained for this prospective, randomized study. Patients were randomized to gastric or postpyloric enteral feedings. Daily tracheal secretion samples were collected, and we used an immunoassay to detect pepsin. Using the data for aspiration and tube type, a univariate unadjusted odds ratio was calculated to assess the risk of aspiration between the 2 tube types. An independent samples t test was used to analyze the hypothesis that microaspiration significantly affects lung recovery from ARDS. Results: Of the 20 study patients, 9 (45%) received nasogastric feeds and 11 (55%) received postpyloric feeds. Western blot analysis for the presence of pepsin in each tracheal aspirate revealed microaspiration in 2 nasogastric (22%) and 2 (18%) postpyloric patients. The nasogastric tube provided a protective effect for aspirating with an odds ratio of .778 (95% confidence interval, .09–6.98). An independent samples t test was used and showed no significant change in PaO2:FiO2 ratio in the aspirating vs nonaspirating group (P = .552). Conclusion: The results of this study indicate that enteral nutrition should not be delayed or stopped to position the tube in patients with ARDS on rotational therapy.
Details
- Title: Subtitle
- Effect of Rotational Therapy on Aspiration Risk of Enteral Feeds
- Creators
- Patrick B Barlow - Graduate School of Medicine, University of Tennessee Medical Center, Knoxville, TennesseeValerie G Sams - Department of SurgeryChristy M Lawson - Department of SurgeryCeba L Humphrey - Department of SurgerySusan L Brantley - Department of SurgeryLeah M Schumacher - Department of SurgeryMichael D Karlstad - Department of SurgeryJamison E Norwood - Department of SurgeryJulie A Jungwirth - Department of SurgeryCaroline P Conley - Department of SurgeryStanley Kurek - Department of SurgeryBrian J Daley - Department of Surgery
- Resource Type
- Journal article
- Publication Details
- Nutrition in clinical practice, Vol.27(6), pp.808-811
- DOI
- 10.1177/0884533612462897
- PMID
- 23087262
- ISSN
- 0884-5336
- eISSN
- 1941-2452
- Language
- English
- Date published
- 12/2012
- Academic Unit
- ICTS; Center for Social Science Innovation; Office of Consultation and Research in Medical Education; General Internal Medicine; Internal Medicine
- Record Identifier
- 9984094406402771
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