The safety of rapid administration of enteral nutrition in acute stroke patients

Suzuki, Kentaro; Sugiyama, Rie; Katano, Tayo; Shigehara, Hiroka; Takagiwa, Taiki; Katafuchi, Izumi; Tanabe, Midori; Ozaki, Hitomi; Numao, Shinichiro; Aoki, Junya; Nishiyama, Yasuhiro; Kimura, Kazumi

doi:10.1016/j.jns.2022.120270

Cited by 2 publications

(4 citation statements)

References 25 publications

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“…The nutritional supplementation effects were evaluated in burn patients [37], in feedback protocols [41] [43], in reducing the enteral diet administration time in aged people with acute stroke [42], in aged patients in general [35], in malnourished patients [15], in aged people with gastrointestinal tumors [44], in older adults aged at least 80 years old [40], in hip surgery patients [20] and in cases of hip arthroplasty with hypoalbuminemia [36].…”

Section: Discussionmentioning

confidence: 99%

“…Nutritional support reduces hospitalization time and the incidence of infectious complications in patients at nutritional risk [35] and increases the possibility of hospital discharge [15]. Rapid enteral nutrition administration can be used safely and has the potential to decrease the time required for feeding in acute stroke cases with severe dysphagia [42]. Hypocaloric enteral nutrition presented higher mortality at 90 days when compared to modified complete enteral nutrition (with prokinetic agents), with 34% versus 17% (OR: 2.89; 95% CI: 1.46 -5.72; p = 0.0023), whereas the difference was less significant between hypocaloric enteral nutrition and complete enteral nutrition: 23% (OR: 1.92; 95% CI: 1.00 -3.69; p = 0.049) [43].…”

Section: Discussionmentioning

confidence: 99%

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Elderly Feeding and Nutrition during Hospitalization: An Integrative Review

Belzarez Guedez,

Helena Lenardt,

Cechinel

et al. 2023

OJN

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Objective: to search in the current literature the elements that exert an influence on feeding and nutrition in hospitalized aged people. Method: the following strategies were used for the integrative review stages: research question (Population or Patients; Exposure; Outcomes); analysis flowchart (Preferred Reporting Items for Systematic Reviews and Meta-analyses); and levels of evidence corresponding to the studies (Oxford Centre for Evidence-Based Medicine). The searches were conducted in the MEDLINE/PubMed, Biblioteca Virtual em Saúde, Embase, CINAHL and Scopus databases. Results: the initial search yielded 1808 studies, of which 34 comprised the analysis corpus after applying the inclusion/exclusion criteria. The assessments corresponding to nutritional status and to the risk factors for hospitalized aged people are fundamental in defining the diet. An association was found between inadequate energy intake, lack of appetite, infections, malignity, delirium and need for assistance in feeding. Dysphagia affected nutritional status and was associated with multimorbidities, cognitive impairment, malnutrition, higher dependence for the activities of daily living, and greater care need. Nutritional support improved the perioperative nutritional status, in addition to reducing the hospitalization times and the number of infectious complications. Conclusion: the main disorder that hinders meeting the nutritional needs is dysphagia, and is associated with aged people's multimorbidity and dependence. The results provide geriatric and gerontological knowledge about elderly nutrition, in addition to targeting preventive and intervention treatments and care during hospitalization.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Elderly Feeding and Nutrition during Hospitalization: An Integrative Review

Belzarez Guedez,

Helena Lenardt,

Cechinel

et al. 2023

OJN

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“…A previous observational study ( 9 ) showed that the proportion of patients with one or more complications, defined as vomiting, diarrhea, or pneumonia, was 22/45 (48.9%) in the rapid EN group and 14/26 (53.8%) in the conventional EN group. Based on previous reports, the non-inferiority margin was defined as a minimum clinically important difference (MCID) of 5% in the outcome ( 13 ).…”

Section: Methodsmentioning

confidence: 96%

“…Previous studies have demonstrated the potential for safe and rapid EN administration ( 9 ). We hypothesized that rapid EN administration is as safe as conventional administration.…”

Section: Introductionmentioning

confidence: 99%

The randomized study of enteral nutrition with rapid versus conventional administration in acute stroke patients; the protocol of rapid EN trial

Suzuki,

Onodera,

Sugiyama

et al. 2024

Front. Neurol.

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RationaleEnteral nutrition is beneficial for stroke patients with oral intake difficulties. However, it is time consuming and may interfere with routine medical care. Therefore, there is a clinical benefit if enteral nutrition can be safely administered in a short time. Although our retrospective study showed the safety of rapid administration, it remains unclear whether rapid administration of enteral nutrition is as safe as conventional administration.AimThe randomized study of Enteral Nutrition with Rapid versus conventional administration in acute stroke patients (Rapid EN trial) aims to clarify the safety of rapid feeding of enteral nutrition compared with conventional feeding.Methods and designThis is an investigator-initiated, multicenter, prospective, randomized, open-label, blinded end-point clinical trial. Eligible criteria include acute stroke patients who have difficulty with oral intake defined as severe altered consciousness (Japan Coma Scale 10–300) or modified water swallowing test <4. The target enrollment is 700 patients, with 350 patients receiving rapid enteral nutrition at a rate of 100 mL in 5 min (Rapid EN group) and 350 patients receiving conventional enteral nutrition at a rate of 100 mL in 30 min (Conventional EN group).Study outcomeThe primary outcome is the incidence of one or more complications of vomiting or diarrhea or pneumonia within 7 days would be non-inferior in the rapid EN group compared to the conventional EN group. Secondary outcomes were total time spent on enteral nutrition within 7 days from enteral nutrition, the incidence of vomiting, diarrhea and pneumonia within 3 or 7 days, and the rate of favorable clinical outcome.DiscussionSince no previous reports have focused on the speed of administration, we felt it was necessary to prove the safety of rapid administration. If this study shows positive results, it will not only benefit patients, but also reduce the burden of medical care. We believe this study is novel and will be useful in clinical practice.Clinical trial registrationhttps://rctportal.niph.go.jp/s/detail/um?trial_id=UMIN000046610 Identifier UMIN000046610.

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The safety of rapid administration of enteral nutrition in acute stroke patients

Cited by 2 publications

References 25 publications

Elderly Feeding and Nutrition during Hospitalization: An Integrative Review

Elderly Feeding and Nutrition during Hospitalization: An Integrative Review

The randomized study of enteral nutrition with rapid versus conventional administration in acute stroke patients; the protocol of rapid EN trial

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