Incidence of gastroesophageal reflux associated with percutaneous endoscopic gastrostomy contrast agent viscosity: a randomized controlled crossover trial

Shimizu, Akira; Muramatsu, Hirohito; Kura, Toshiro; Sakata, Takashi

doi:10.1038/ejcn.2016.76

Cited by 10 publications

(26 citation statements)

References 9 publications

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“…After screening 912 records, 39 potentially relevant studies were identified ( Figure 1 ). Fifteen of these 39 studies met the study inclusion criteria (Muramatsu et al, 2018 [ 17 ]; Ishii et al, 2006 [ 18 ]; Togashi & Paku 2012 [ 19 ]; Paku et al, 2012 [ 20 ]; Nakahori et al, 2011 [ 21 ]; Abe et al, 2011 [ 22 ]; Muramatsu et al, 2010 [ 23 ]; Kanie et al, 2004 [ 11 ]; Shizuku et al, 2011 [ 24 ]; Nagasawa 2009 [ 25 ]; Toh et al, 2016 [ 26 ]; Tabei et al, 2018 [ 27 ]; Nishiwaki et al, 2009 [ 12 ]; Shimizu et al, 2016 [ 13 ]; Higashiguchi et al, 2014 [ 28 ]). The 15 studies comprised 10 RCTs [ 17 , 18 , 19 , 20 , 21 , 22 , 23 , 26 , 27 , 28 ] and five crossover trials [ 11 , 12 , 13 , 24 , 25 ].…”

Section: Resultsmentioning

confidence: 99%

“…They are inexpensive, covered by insurance, and can be used in a variety of settings. In recent years, semi-solid nutrient formulations with higher viscosity than liquid nutrients have been reported to be effective in reducing gastroesophageal reflux (GER) in patients who have undergone percutaneous endoscopic gastrostomy [ 11 , 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

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Semi-Solid Nutrients for Prevention of Enteral Tube Feeding-Related Complications in Japanese Population: A Systematic Review and Meta-Analysis

et al. 2020

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The aim of this systematic review was to assess the best available evidence on semi-solid nutrients for prevention of complications associated with enteral tube feeding (ETF). PubMed (MEDLINE), EMBASE, Cochrane Central Register of Controlled Trial, Ichushi-web, and World Health Organization International Clinical Trials Registry Platform databases were searched for relevant articles. Randomized controlled trials (RCTs), cluster RCTs, and crossover trials comparing the effects of semi-solid nutrients with those of control interventions in patients on ETF were included in the review. The primary outcome was development of gastroesophageal reflux (GER). Eight RCTs and five crossover trials involving 889 study participants in total were examined via meta-analysis. The meta-analysis showed that semi-solid nutrients significantly decreased the risk of GER (risk ratio 0.39; 95% confidence interval (CI) 0.21 to 0.73) and the GER index (mean difference −2.93; 95% CI −5.18 to −0.68). Dwell time in the stomach was significantly shortened (standardized mean difference (SMD) −0.50; 95% CI −0.99 to −0.02), as was care time defined as the time needed to prepare and administer the nutrient solution (SMD −8.02; 95% CI −10.94 to −5.10). Semi-solid nutrients significantly decrease the risk of GER and the dwell time in the stomach in adult patients.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Semi-Solid Nutrients for Prevention of Enteral Tube Feeding-Related Complications in Japanese Population: A Systematic Review and Meta-Analysis

et al. 2020

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“…In PEG patients, the efficacy of semi-solid feed in decreasing or inhibiting GER is not conclusive, with conflicting results being reported 17 18 19. That may be due to differences in the dynamic viscosity of semi-solid feed used in various studies.…”

Section: Discussionmentioning

confidence: 99%

Semi-solid feeds may reduce the risk of aspiration pneumonia and shorten postoperative length of stay after percutaneous endoscopic gastrostomy (PEG)

2016

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Background and study aims: Feeding-related adverse events after percutaneous endoscopic gastrostomy (PEG) such as aspiration pneumonia may result in prolonged hospitalization and postoperative mortality. This study evaluated the efficacy of using semi-solid feeds to reduce feeding-related adverse events and improve clinical outcomes. Patients and methods: Patients who received PEG for enteral nutrition at our hospital between January 2014 and December 2015 were allocated to a postoperative feeding protocol that used either liquid feed or semi-solid feed. Baseline characteristics, postoperative feeding-related adverse events and clinical outcomes in the 2 groups were prospectively analysed and compared. Results: One hundred and seventeen PEG patients (age range: 59 – 97 years, male: 53) were enrolled with 72 patients given liquid feed and 45 patients receiving semi-solid feed. Baseline characteristics were similar in both groups. The semi-solid feed group experienced fewer incidence of feeding-related aspiration pneumonia (2.2 % vs. 22.2 %, P < 0.005) and shorter postoperative hospital length of stay (12.7 days vs. 18.8 days, P < 0.01). Significant differences were not observed in the frequency of peristomal infection (11.1 % vs. 12.5 %, P = 0.82), feeding-related diarrhea (2.2 % vs. 12.5 %, P = 0.09) and 30-day mortality rates (2.2 % vs. 8.3 %, P = 0.25). Conclusions: Semi-solid feeding may reduce the risk of aspiration pneumonia and shorten postoperative hospital length of stay after PEG. Semi-solid feeds are safe to use and can be employed either as a first line feeding protocol or an alternative when liquid feeding is unsuccessful.

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“…Administration of a semi-solid enteral formula, instead of a liquid formula, through a PEG tube is becoming a common practice in Japan to prevent enteral nutritionrelated complication such as vomiting, GER, and aspiration pneumonia [8]. These complications have been reported to be improved with semi-solid formulas compared with liquid formulas [11][12][13][14].…”

Section: Discussionmentioning

confidence: 99%

“…Enteral tube feeding via percutaneous endoscopic gastrostomy (PEG) has been widely applied in Japan for the long-term alimentation of the patients such as those with dysphagia [8]. Aspiration pneumonia is a serious adverse event in enteral tube feeding [9,10].…”

Section: Doi: 101159/000492674mentioning

confidence: 99%

Feasibility of International Proposed Standardized Enteral Connector for Semi-Solid Formula Feeding

Maruyama¹,

Iijima²,

Ishibashi³

et al. 2018

Ann Nutr Metab

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Background/Aims: The current study was undertaken to assess if the semi-solid formulas could be used with a new ENFit connector with similar force to current percutaneous endoscopic gastrostomy (PEG) tubes. Methods: Experiment 1: We measured the applied pressure (force) needed to compress the syringe containing 7 viscous semi-solid formulas with a 20 Fr PEG tube and low-profile tube through the ENFit connector or the current connector. Experiment 2: This experiment was conducted to evaluate the compression force through 2 connectors in 3 infusion velocity, 7 PEG tube types with 2 semi-solid formulas. Results: Experiment 1: The force needed to compress the syringe through the ENFit connector was higher in 3 semi-solid formulas with a 20 Fr low-profile tube; otherwise, there were no significant differences. Experiment 2: Each formula required a higher force in the ENFit connector in 6 settings out of 21. Conclusions: The ENFit connector will likely not show any remarkable change in the force to administer the semi-solid formula. However, a higher force was required under some conditions in the prototype ENFit connector. Further investigation of sensory test is needed to confirm the feasibility of the ENFit connector for using the semi-solid formulas.

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Incidence of gastroesophageal reflux associated with percutaneous endoscopic gastrostomy contrast agent viscosity: a randomized controlled crossover trial

Abstract: Semisolid contrast agents reduced the incidence of GER after PEG.

Cited by 10 publications

References 9 publications

Semi-Solid Nutrients for Prevention of Enteral Tube Feeding-Related Complications in Japanese Population: A Systematic Review and Meta-Analysis

Semi-Solid Nutrients for Prevention of Enteral Tube Feeding-Related Complications in Japanese Population: A Systematic Review and Meta-Analysis

Semi-solid feeds may reduce the risk of aspiration pneumonia and shorten postoperative length of stay after percutaneous endoscopic gastrostomy (PEG)

Feasibility of International Proposed Standardized Enteral Connector for Semi-Solid Formula Feeding

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