Recent Advances in Enteral Nutrition

Ribeiro

European Journal of Pain

et al. 2019

Background Pain is a common experience during nasoenteral catheterization. Although the procedure causes discomfort and distress to patients, procedural pain remains neglected and undertreated. Objective To evaluate the analgesic efficacy of the use of 10% lidocaine spray during nasoenteral catheterization. Method A randomized, triple‐blind trial of 50 patients was performed. The patients were randomly assigned to two groups: an intervention group (IG), in which 10% lidocaine spray combined with 2% lidocaine gel was used, and a control group (CG), in which a saline solution spray combined with 2% lidocaine gel was used. Pain and discomfort were assessed during and after nasoenteral catheterization using numerical rating scale (NRS) and the visual analogue scale (VAS), respectively. Results Intervention group participants reported lower pain scores during (0.20 ± 0.71 vs. 5.00 ± 2.84, p < .001; |d| = −0.677) and after (0.00 ± 0.00 vs. 2.80 ± 2.83, p < .001; |d| = −0.718) nasoenteral catheterization compared to the CG. Conclusion Spraying 10% lidocaine spray before nasoenteral catheterization was most effective for relieving discomfort and pain, with lower pain and discomfort recorded in NRS and VAS. Topical administration of 10% lidocaine spray is therefore a suggested measure for procedural pain relief related to nasoenteral catheterization. Significance The use of 10% lidocaine spray was more effective in relieving procedural pain and discomfort during nasoenteral catheterization. Patients who received 10% lidocaine spray registered lower discomfort and pain scores than those from 2% lidocaine gel group; there were less complications among patients in the IG.

Section: Discussionmentioning

confidence: 99%

Analgesic efficacy of 10% lidocaine spray during nasoenteral catheterization: Randomized triple‐blind trial

Ribeiro

European Journal of Pain

et al. 2019

Section: Introductionmentioning

confidence: 99%

“…Sometimes, enteral tube feeding is needed to support patients with human immuno-deficiency virus (HIV), those who fail to thrive and individuals with learning and intellectual disability and may involve patients in their own homes, residential care, nursing homes, acute hospitals including intensive care units [6,11,12]. There is evidence that enteral tube feeding can improve wound healing, reduce length of hospital stay, prolong life and relatively save costs [11]. For instance, diabetes specific enteral formula has been found to be effective in managing patients with diabetes on enteral nutrition [13] while in patients with esophageal cancer, early enteral nutrition was effective in reducing the incidence of postoperative pulmonary infection, enhancing early recovery and reducing length of hospital stay and hospital cost [14].…”

Section: Introductionmentioning

confidence: 99%

The Effect of Enteral Tube Feeding on Patients’ Health-Related Quality of Life: A Systematic Review

Ojo

Keaveney²,

Wang

et al. 2019

Nutrients

Self Cite

Patients with functional gastrointestinal tract who are unable to meet their nutritional requirements may benefit from the use of enteral nutrition via feeding tubes which could be nasogastric, percutaneous endoscopic gastrostomy and jejunostomy. Although enteral tube feeding has been shown to promote nutritional status, improve wound healing, and enhance patients’ quality of life (QoL), evidence of tube and feed complications and reduced QoL has also been reported. Despite the increasing prevalence of patients on enteral tube feeding, no systematic review examining the role of enteral tube feeding on patients’ QoL appears to have been published. Aim: The aim of this systematic review is to evaluate the effect of enteral tube feeding on patients’ QoL. Method: Three databases (EMBASE, Pubmed, and PsycINFO) plus Google Scholar were searched for relevant articles based on the Population, Intervention, Comparator, Outcomes (PICO) framework. The review was in line with preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines and involved the use of synonyms and medical subject headings. In addition, search terms were combined using Boolean operators (AND/OR) and all the articles retrieved were exported to EndNote for de-duplication. Results: Fourteen articles which met the criteria were included and three distinct areas were identified: the effect of early versus late enteral tube feeding on QoL; the QoL of patients on gastrostomy versus standard care, and the effect of enteral tube feeding on QoL. Overall, nine studies reported improvement in the QoL of patients on enteral tube feeding, while five studies demonstrated either no significant difference or reduction in QoL. Some factors which may have influenced these outcomes are differences in types of gastrostomy tubes, enteral feeding methods (including time patients spent connected to enteral feed/pump), and patients’ medical conditions, as well as the generic and/or type of QoL measuring instrument used. Conclusion: Most reviewed studies suggest that enteral tube feeding is effective in improving patients’ QoL. The use of enteral tube feeding-specific QoL measuring instruments is recommended for future research, and improved management strategies including use of mobile enteral feeding pumps should further enhance patients’ QoL. More studies on the effect of delivery systems/enteral feeding pumps on QoL are needed as research in this area is limited.

“…[ 7 ]. In addition, more and more serious aging society, various diseases mentioned above, the swallowing difficulties and malnutrition resulted from various complications, are all the main reasons why rapidly increasing enteral nutrition is needed [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Semi-automated ultrasound guidance applied to nasogastrojejunal tube replacement for enteral nutrition in critically ill adults

Liu

Yang

et al. 2018

BioMed Eng OnLine

Background and objectiveAt present, the enteral nutrition approaches via nose and duodenum (or nose and jejunum) are the preferred method of nutritional support in the medical engineering field, given the superiority of in line with physiological processes and no serious complication. In this study, the authors adopted saline as the acoustic window, and gave enteral nutrition support to critically ill patients, via the nasogastrojejunal approach guided by semi-automated ultrasound. These above patients benefited a lot from this kind of nutrition support treatment, and we aimed to report the detailed information.MethodsCritically ill patients (n = 41) who had been treated with hospitalized intestine nutrition were identified. The Apogee 1200 ultrasonic diagnostic apparatus, and nasogastrojejunal tubes were adopted to carry out intestine nutrition treatment guided by semi-automated ultrasound. In order to confirm the specific positions of cardia, gastric body, antrum of stomach, and pylorus, the semi-automated ultrasound was utilized to probe the stomach cavity. And then, the ultrasonic probe was placed in the cardia location, and the nasogastrojejunal tube was slowly inserted through the metal thread. After operation, the nursing service satisfaction of patients and mean operation time were calculated, respectively.ResultsAll the patients were treated with enteral nutrition via nasogastrojejunal tube, and the whole procedure was under the guidance of semi-automated ultrasonography. The end of the feeding tube is attached to the surface of the stomach with a greater curvature, which can be bent on account of a no gastric peristalsis squeeze function, and thereby were prevented from entering into the antrum and pylorus locations. After this procedure, the mental thread was taken out, and the tube was pushed forward by a “drift” approach in order to allow it to enter into the intestine. The total nursing service satisfaction of patients was 90.24%, and the total incidence of adverse reactions was 17.07%.ConclusionsIn summary, the application of saline can be taken as sound window, and the metal wire as the tracking target, the bedside nasogastrojejunal tube guided by semi-automated ultrasound is an effective feeding tube placement method, with relatively good clinical application value in medical engineering.