ABSTRACT
Acute pancreatitis (AP) is an acute inflammatory disease of various severity, characterized by upper abdominal pain, elevated pancreatic enzymes, and changes in imaging features of the pancreas. According to the degree of pancreatic injury and the presence and duration of systemic organ failure, AP is classified into mild, moderate, or severe disease. Most AP patients experience mild disease and recover quickly, while up to 20% progress to moderate or severe disease, with an estimated risk of death as high as 30%. Severe acute pancreatitis (SAP) is a clinical emergency with a critical condition and poor prognosis, especially in patients with pancreatic and/or peripancreatic tissue infection and necrosis. AP is essentially an inflammatory process that can lead to protein catabolism and increased metabolic rates, further resulting in negative nitrogen balance. The goal of nutritional support therapy for AP is to correct negative nitrogen balance, reduce inflammation, and improve prognosis. Enteral nutrition therapy is an important component of clinical treatment of SAP. This review aims to summarize the nutritional support treatment in AP based on the existing clinical data and experience.
ABSTRACT
Objective:To investigate the clinical efficacy of different enteral nutrition methods combined with swallowing rehabilitation training in the treatment of Alzheimer's disease complicated by dysphagia.Methods:A total of 120 patients with Alzheimer's disease and dysphagia who received treatment in the Department of Geriatric Medicine, the Second Hospital of Jinhua from October 2019 to March 2021 were included in this study. They were randomly and evenly divided into four groups: A, B, C, and D. Patients in groups A, B, C, and D were given nasogastric tube feeding, naso-intestinal tube feeding, nasogastric tube feeding + swallowing rehabilitation training, and naso-intestinal tube feeding + swallowing rehabilitation training, respectively. After 12 weeks of treatment, total response rate, nutritional status, and complications were compared between the four groups.Results:After 12 weeks of treatment, total response rate in group D was the highest (100.0%), which was significantly higher than that in the other three groups (group A: 13.3%; group B: 40.0%; group C: 73.3%; χ2 = 45.88, 25.71, 9.23, all P < 0.05). After treatment, the nutritional status [body mass index (BMI): (21.42 ± 1.85) kg/m 2, (23.17 ± 2.03) kg/m 2] and patient satisfaction (60.0%, 100.0%) in groups C and D were significantly superior to those in group A [BMI: (19.01 ± 1.72) kg/m 2; patient satisfaction: 10.0%) and group B [BMI: (19.86 ± 1.69) kg/m 2; patient satisfaction: 33.3%]. Group D had the best nutritional status ( t = 7.01, 5.14, 1.78, all P < 0.05) and the highest patient satisfaction ( χ2 = 49.09, 30.00, 15.00, all P < 0.001). Conclusion:Naso-intestinal tube feeding combined with swallowing rehabilitation training is the best treatment for Alzheimer's disease complicated by dysphagia among the studied enteral nutrition feeding methods and therefore deserves clinical promotion.
ABSTRACT
Adhesive intestinal obstruction is the most common type of ileus, and conserva-tive treatment serves as its preferred treatment option. In the course of conservative treatment, gastrointestinal decompression will relieve symptoms, prevent ileus progression and promote gas-trointestinal function recovery, which has significant clinical effects. Currently, decompression effects of nasointestinal tubes and nasogastric tubes are controversial. There is a previous Meta-analysis evaluating decompression effects of these two methods, but this analysis includes non-randomized controlled trial and lacks research about Chinese patients. Therefore, the authors con-duct a Meta-analysis to evaluate decompression effects of nasointestinal tubes versus nasogastric tubes for adhesive intestinal obstruction.
ABSTRACT
Objective:To evaluate the effectiveness and safety of preemptive nasogastric tube placement for improving nutritional status and clinical outcomes in hospitalized infants with congenital heart disease.Methods:Children from 0 to 12 months with congenital heart disease hospitalized in cardiovascular center of Children's Hospital of Fudan University from February to July 2018 were selected as control group through continuous sampling. Children hospitalized were selected from September 2018 to February 2019 as intervention group. The control group followed the current feeding method, the intervention group used preemptive nasogastric tube placement. The nutritional indicators, feeding indicators and clinical outcomes of the two groups were compared to evaluate the intervention effect.Results:The serum albumin and prealbumin of the children in the intervention group were (36.81±4.59) g/L and (162.74±48.17) g/L, which were higher than those in the control group (34.80±5.21) g/L and (142.98± 33.96) g/L, the difference between the two groups was statistically significant ( t values were -2.721, -3.169, both P<0.05); the daily enteral intake, calorie intake and single enteral calorie intake of children in the intervention group were (124.93±27.97) ml·kg -1·d -1, (376.48±88.53) kj·kg -1·d -1, (48.39±9.13) kj·kg -1·time -1, higher than the control group (114.74±30.63) ml·kg -1·d -1, (330.01±90.75) kj·kg -1·d -1, (44.24±13.31) kj·kg -1·time -1, the difference between the two groups was statistically significant ( t values were -2.511, -3.750, -2.382, all P<0.05). the incidence of feeding difficulties in the intervention group was 4.95% (5/101) lower than 14.68% (16/109) of the control group, the difference between the two groups was statistically significant ( χ2 value was 5.513, P<0.05); the proportion of children in the intervention group reaching the target feeding amount when discharged from the hospital was 97.03% (98/101), higher than 84.40% (92/109) of the control group, the difference between the two groups was statistically significant ( χ2 value was 9.699, P<0.05). Conclusions:Preemptive nasogastric tube placement is safety and effectively for patients with congenital heart disease in clinical infants. but it still needs a large sample for a long time to confirm its effectiveness.
ABSTRACT
Objective:To systematically retrieve, evaluate and summarize the research evidence on the measurement method of adult nasogastric tube indwelling length and provide a basis for clinical nursing practice.Methods:To search for Cochrane Library(CD-SR, DARE), Joanna Briggs(JBI), PubMed (MEDLINE), Web of Science electronic database, China Biomedical Literature Database (CBM), Wanfang Database, China Knowledge Network from the establishment of the database to December 2018. Two researchers independently evaluated the quality of the literature and extracted the data.Results:A total of 9 articles were included in the study. The recommended anatomical landmarks for measuring the length of the inserted gastric tube included XNE, NEX, XJN, Hanson method, GWNUF model, earlobe to xiphoid to navel-nose tip to earlobe NEX 10 cm. The tip of the nasogastric tube and all its lateral hole locations obtained by the Hanson method, the GWNUF model, and the XEN 10 cm method were more likely to be located in the stomach.Conclusion:Although NEX is an external measurement method that is widely used in clinical practice, it has proven to be insufficiently accurate and has considerable risks. Therefore, the method of measuring the length of the nasogastric tube insertion should be carefully selected for teaching or use in practice.
ABSTRACT
Resumen El manejo de la nutrición en pancreatitis aguda ha sido cuestión de debate. Durante muchos años el concepto de reposo pancreático fue generalizado y aceptado en el manejo de la pancreatitis aguda. Actualmente se conoce que la nutrición temprana permite mantener la integridad de la barrera intestinal, que previene la aparición de complicaciones infeccionas y se asocia con una menor estancia hospitalaria, menos complicaciones y un mejor pronóstico. En esta revisión se discuten las principales ventajas de la nutrición temprana en pancreatitis aguda, la seguridad de la misma y la vía de administración.
Abstract Nutrition management in acute pancreatitis has been a matter of debate worldwide. For many years, the concept of pancreatic rest was widespread and accepted to treat acute pancreatitis. However, current knowledge of early nutrition allows maintaining the intestinal barrier's integrity, preventing the occurrence of infectious complications, which is associated with a shorter hospital stay, fewer complications, and better prognosis. This review presents the main advantages of early nutrition in acute pancreatitis, its safety, and the route of administration.
Subject(s)
Humans , Pancreatitis , Nutritional Sciences , RestABSTRACT
At present, the dosage and administration items in the marketing instructions of some oral solid brand drugs approved in China include related contents for administration via nasogastric tube. In order to achieve consistency with the original drugs in quality and efficacy, the generic drugs investigators should confirm whether the generic drugs and the original drugs have the same in vitro characteristics under the conditions of administration by nasogastric tube. The purpose is to eliminate the clinical risks brought by the way of administration. This article summarizes the experimental design and evaluation points for the in vitro comparative study of the solid oral generic drugs which can be administered by nasogastric tube, while referring to the individual drug guidelines issued by FDA and the related literature published, so as to provide a reference for the technical system construction for the consistency evaluation of oral solid dosage forms.
ABSTRACT
Tube feeding is used to provide nutritional support to patients who have difficulty taking food orally. A nasogastric tube is commonly used for these patients but there are some complications. Therefore, the oro-esophageal tube feeding method was developed to avoid these disadvantages. A 33-year-old male with a history of right basal ganglia intracranial hemorrhage was admitted to the rehabilitation department for the treatment of dysphagia caused by a new onset left basal ganglia intracranial hemorrhage. After the videofluoroscopic swallowing study, the nasogastric tube feeding was changed to intermittent feeding via an oro-esophageal tube. Unfortunately, the patient swallowed the tube during insertion. Hence, an emergent endoscopy was performed for tube removal. This article reports a rare case of a patient who underwent oro-esophageal tube removal with an esophagogastroduodenoscopy after tube swallowing during insertion. The insertion of an oro-esophageal tube requires a careful approach after considering the cognitive function, muscle strength, and family education.
Subject(s)
Adult , Humans , Male , Basal Ganglia , Cognition , Deglutition , Deglutition Disorders , Education , Endoscopy , Endoscopy, Digestive System , Enteral Nutrition , Intracranial Hemorrhages , Methods , Muscle Strength , Nutritional Support , RehabilitationABSTRACT
Objective To study the effect of evidence-based nursing in patients with cerebral apoplexy in ICU by blind bedside spiral nasointestinal tube application.Methods To choose between September 2016 and September 2017 in our hospital ICU were 140 cases of patients with cerebral apoplexy as analysis object,randomly divided into two groups,two groups all use bedside blind spiral nose long intestinal tube technology,the control group using conventional nursing method for nursing,observation group using evidence-based nursing intervention,compared two groups of a success rate of catheter,accident to take off the tube (unscheduled decannulation rate),reflux hiccups,vomiting incidence of aspiration and patient satisfaction.Results The success rate of catheterization in the observation group was higher than that in the control group,and the incidence of accidental catheterization was lower than that in the control group.The incidence of reflux hiccup and vomiting aspiration was significantly lower than that in the control group,and the patient satisfaction was higher than that in the control group (all P＜0.05).Conclusion For patients with cerebral apoplexy in the ICU bed of blind plug spiral nasal bowel technology combined evidence-based nursing intervention,clinical effect is remarkable,improve the success rate of catheter,reduces the surprise success rate of tube,unscheduled tube drawing number,reduces the incidence of reflux hiccups,vomiting aspiration,improve patient satisfaction and quality of life.
ABSTRACT
Objective@#To investigate the effects of "Q" nose paste on fixing nasogastric tube.@*Methods@#Totally 167 patients with nasogastric tube were divided into the observation group(80 cases) and the control group(87 cases) by random digits table method.The observation group fixed nasogastric tube using "Q" nose paste,while the control group using "π" nose paste. The occurrence rate of pressure injury of nasal mucosa and nasogastric tube dislocation, nurses′ operation time of pasting, removing nose paste, the time intervals of exchanging nose paste were observed and compared between the two groups.@*Results@#The occurrence rate of pressure injury of nasal mucosa in the observation group was 0,and it was significantly lower than the control group 6.897% (6/87), the difference was statistic between the two groups (χ2=5.523, P<0.05). The nurses′ operation time of pasting and removing nose paste in the observation group was (18.99 ± 1.13), (10.20 ± 0.96) s, and they were significantly shorter than the control group (38.97 ± 1.28), (20.38 ± 1.30) s, the difference was statistic between the two groups (t=-106.521, -57.266, P<0.01). The time intervals of exchanging nose paste in the observation group was (3.78 ± 0.98) d, and it was significantly lower than the control group (2.07 ± 0.91) d, the difference was statistic between the two groups(t=11.628, P<0.05). There was no statistical difference in the rate of nasogastric tube dislocation between the two groups (P>0.05).@*Conclusions@#Application of "Q" nose paste in fixation of nasogastric tube can decrease the incidence of nasal mucosa pressure ulcers, it is conducive to extend the interval of nasal sticker replacement and improve work efficiency, thus is worthy of clinical application.
ABSTRACT
OBJECTIVE: To investigate the influence of a nasogastric tube (NGT) on swallowing simulated saliva in stroke patients. METHODS: Three groups of participants were enrolled into the study: group A (20 stroke patients with a NGT), a control group B (25 stroke patients without a NGT), and group C (25 healthy adults with no brain lesions or dysphagia). Participants swallowed 1 mL of water to simulate saliva. Patients in group A were tested twice: once with a NGT (group A1) and once after the NGT was removed (group A2). The distance of hyoid bone movement was measured by subtracting the shortest distance between the mandible and hyoid bone (S) from the distance at resting state (R) measured with ultrasonography. The degree of the movement was calculated by (R–S)/R. The trajectory area of hyoid bone movement (Area) and the interval between the beginning of hyoid bone movement and the moment of the shortest hyoid−mandible approximation (Interval) was calculated by a computer program. RESULTS: From group A: R–S and (R–S)/R of group A2 at 1.14±0.36 cm and 0.30±0.09 cm and were significantly greater than those of group A1 at 0.81±0.36 cm and 0.22±0.08 cm (p=0.009 and p=0.005). After removing the NGT as seen in group A2, R–S and (R–S)/R were improved to the level of those of group B at 1.20±0.32 cm and 0.30±0.09 cm (p=0.909 and p=0.997). The Area of group A2 was larger and the Interval of group A2 was shorter than those of group A1 though a comparison of these factors between A2 and A1 did not show a statistically significant difference. CONCLUSION: A NGT interferes with the movement of the hyoid bone when swallowing 1 mL of water in stroke patients though the movement is restored to normal after removing the NGT.
Subject(s)
Adult , Humans , Brain , Deglutition Disorders , Deglutition , Hyoid Bone , Mandible , Saliva , Stroke , Ultrasonography , WaterABSTRACT
The nutritional support of acutely ill patients is very important and early enteral nutrition is recommended. Feeding via the nasogastric route is used widely for its ease of access if the patient cannot maintain volitional food intake. If the position of the tip or side holes of the nasogastric tube (NGT) is above the gastroesophageal junction, there is the possibility of retention and solidification of the administered enteral feeding formula in the esophagus. Therefore, the tip of the NGT should be checked carefully; a chest radiograph to confirm its position can be considered, especially in patients with a higher risk of aspiration and gastroesophageal reflux. In addition, careful consideration of the risk factors that can trigger esophageal obstruction is required when feeding patients in the intensive care unit. This paper describes two unusual cases of esophageal obstruction caused by the solidification of residue of an enteral feeding formula.
Subject(s)
Humans , Eating , Enteral Nutrition , Esophagogastric Junction , Esophagus , Gastroesophageal Reflux , Intensive Care Units , Nutritional Support , Radiography, Thoracic , Risk FactorsABSTRACT
Objective To explore the effect of food improvement on the retention time of nasogastric tube in stroke patients with dysphagia. Methods Sixty cases were assigned to the control group(30 cases) and the experimental group(30 cases) by random digits table method, the control group received routine nasogastric feeding, and the experimental group were given texture modified foods and thickened liquid to try to help them eating through the mouth. The feeding tube was pull out when the person in experimental group was capable of taking texture modified foods and thickened liquid without difficulty,while the tube was pull out when the person in control group was able to eat regular food and drink regular fluids. The retention time of nasogastric tube of two groups was compared. Results The retention time of nasogastric tube was(6.13±2.96)d in the experimental group and(18.93±7.58)d in the control group, there was significant difference (t =-8.162, P<0.01). Conclusions Food improvement can effectively shortenthe retention time of nasogastric tube in stroke patients with dysphagia.
ABSTRACT
Resumen Presentamos el caso clínico de un paciente que manifestó un anudamiento en la porción distal de una sonda nasogástrica, sin complicaciones, y realizamos una breve revisión de las posibles complicaciones asociadas al uso de este tipo de dispositivos.
Abstract We report the case of a patient who presented a knot in the distal portion of a nasogastric tube, without transcendence, and perform a brief review of the possible complications associated with the use of this type of devices.
Resumo Apresentamos o caso de um paciente que apresentou um nó na porção distal da sonda nasogástrica sem complicações. Realizamos uma breve revisão das possíveis complicações associadas ao uso deste tipo de dispositivos.
ABSTRACT
OBJECTIVE: To evaluate the safety of nasogastric tube (NGT) removal and change to oral feeding with a food thickener for acute stroke patients in whom a videofluoroscopic swallow study (VFSS) confirmed thin liquid aspiration. METHODS: We retrospectively examined data of 199 patients with first stroke who were diagnosed with dysphagia from 2011 to 2015. Swallowing function was evaluated using VFSS. Patients included in this study were monitored for 4 weeks to identify the occurrence of aspiration pneumonia. The penetration-aspiration scale (PAS) was used to assess VFSS findings. The patients were divided into thin-liquid aspiration group (group 1, n=104) and no thin-liquid aspiration group (group 2, n=95). RESULTS: The feeding method was changed from NGT feeding to oral feeding with food thickener (group 1) and without food thickener (group 2). The PAS scores of thin and thick liquids were 6.46±0.65 and 1.92±0.73, respectively, in group 1 and 2.65±0.74 and 1.53±0.58, respectively, in group 2. Aspiration pneumonia developed in 1.9% of group 1 and 3.2% of group 2 (p=0.578), with no significant difference between the groups. CONCLUSION: We concluded that removing the NGT and changing to oral feeding with a food thickener is a safe food modification for acute stroke patients with thin liquid aspiration. Therefore, we recommend that VFSS should be conducted promptly in acute stroke patients to avoid unnecessary prolonged NGT feeding.
Subject(s)
Humans , Deglutition , Deglutition Disorders , Feeding Methods , Pneumonia, Aspiration , Retrospective Studies , StrokeABSTRACT
Objective To investigate the status and influencing factors of the methods used by nurses verifying the nasogastric tube placement blinded inserted in adult, and to explore the best practice of nursing staff to verify the nasogastric tube placement. Methods We designed the questionnaire and conducted survey to the clinical nursing staff in accordance with the American Association of Critical-Care Nurses practice alert. Results Air bolus auscultation (70.53％,675/957) and aspirate appearance (68.97％,660/957) were the most used method during insertion procedure. There was insufficient in the cognition of X-ray as the gold standard and the use in clinical.The department, work years, specialist nursesand hospitallevel impact X-ray use(all P <0.05).Age, education,title,hospital level, specialist nurses and department impact the cognition of X-ray as the gold standard(all P <0.05). Conclusions Nurses still use the traditional methods to verify the nasogastric tube placement. There is a certain gap between clinical practice and AACN practice alert in themethods used to verify nasogastric tube placement.As the gold standard to verify gastric tube placement, the use and cognition of X-ray are impacted by many factors, including the department, specialist nurses, hospital level, et al. Therefore, hospital should establish a knowledge sharing platform, which will help to spread the advantages and disadvantages of various methods used in verifying the nasogastric tube placement, and then to strengthen the cognition with different people. Furthermore, based on potential influencing factors, it is necessary to further explore new bedside effective method of verifying the nasogastric tube placement and seek the best practice to validate the method of blind intubation of nasogastric tube.
ABSTRACT
Objective To explore the effectiveness,feasibility and suitability of the guideline for nasogastric tube feeding in adult patients.Methods Based on the Ottawa Model of Research Use as framework,we screened relevant evidence from guidelines,and developed new nasogastric tube feeding nursing procedure.Nursing knowledge,the rate of compliance to new procedure and the incidence of complications of nasogastric tube feeding were used to evaluate the clinical effects of the guideline.Results Nurses' knowledge increased significantly(P＜0.05).Nurses had a high degree of implementation of the new procedure,with the rate of over 85％.Compared with the control group,the rate of complications of nasogastric tube feeing in the experimental group was lower than that in the control group.Especially,the rates of reflux and aspiration were significantly lower(P＜0.05).Both rates of tube shedding and skin damage in the intervention group were decreased significantly(P＜0.05).Conclusion The nasal feeding nursing guideline in our clinical scenarios has its effectiveness,feasibility and suitability.
ABSTRACT
Objective To reduce the rate of unscheduled nasogastric extubation for the patients in neurology department.Methods A nursing care team was set up for a thematic activity to reduce the rate of nasogastric tube unscheduled extubation.The team analysed the situations of 164 patients with nasogastric intubation in the neurology department,specifying the problems,deciding their aims and working out the strategies.Result The rate of unscheduled nasogastric extubation decreased from 19.63％ to 2.12％ and the rate of nursing omission decreased from 9.93％ to 2.59％ (P＜0.05).Conclusion The improvement activity of nursing projects can effectively reduce the rate of unscheduled nasogastric extubation and improve the quality of nursing care.
ABSTRACT
Objective To assess the effect of Chinese Rhubarb in assisting the treatment of severe acute pancreatitis (SAP) by nasojejunal tube (NJ) and nasogastric tube (NG).Methods Cochrane Library, PubMed, Embase, Science Citation Index Expanded-SCIE, EBSCO-CINAHL Complete, SinoMed, VIP network and Wan Fang net were retrieved systematically and randomized controlled trails (RCT) that involved in Chinese rhubarb assisting the treatment of SAP by NJ and NG were searched.According to eligibility and extraction standards, 2 researchers independently selected relevant literature and extracted the relevant data.The quality of literature was evaluated using criteria published by Australian Evidence-Based Health Care Center (2008).RevMan5.3 software was employed for Meta analysis.Results Eleven RCTs were enrolled and the quality of all the 11 papers was B grade.Compared with NG, NJ had lower score of APACHE-Ⅱ, shorter time of decreased CRP, amylase activity, IL-6 and IL-1, and shorter recovery time of bowel function and abdominal pain, and the differences were statistically significant (P<0.01).However, there were no significant differences between two groups on complication rate, mortality, the rate of bowel function failure, the rate of surgical operation and recovery rate.Conclusions Chinese Rhubarb by NJ irrigation in assisting the treatment of SAP can rapidly alleviate abdominal pain, promote bowel function recovery and reduce inflammatory reaction, which had better efficacy than NG.
ABSTRACT
ABSTRACT: This study compared the effects of enteral electrolyte solutions with different osmolarities in Holstein cattle. Eighteen newborn calves were evenly divided into three groups and administered the following treatments: hypotonic electrolyte solution (ESHYPO) containing 4g NaCl, 0.5g KCl, 1g sodium acetate, and 7.5g dextrose diluted in 1,000mL water; isotonic electrolyte solution (ESISO) containing 5g NaCl, 1g KCl, 2g sodium acetate, and 10g dextrose diluted in 1,000mL water; and hypertonic electrolyte solution (ESHYPER) containing 6g NaCl, 1g KCl, 3g sodium acetate, and 15g dextrose diluted in 1,000mL water. Solutions were administered at a rate of 15mL kg-1hr-1 for 12 hours in a continuous flow. All three solutions increased the concentration of plasma sodium, but ESHYPO did not alter the serum osmolarity. Both ESISO and ESHYPO resulted in an increase in volemia.
RESUMO: O presente estudo comparou os efeitos de soluções de eletrolíticas enterais com diferentes osmolaridades administradas em fluxo contínuo. Dezoito animais foram divididos em três grupos: Solução eletrolítica hipotônica (SEHIPO) contendo 4g de NaCl; 0,5g de KCl; 1g de acetato de sódio; 7,5g de dextrose diluídos em 1.000mL de água; Solução eletrolítica isotônica (SEISO) contendo 5g de NaCl; 1g de KCl; 2g de acetato de sódio; 10g de dextrose diluídos em 1.000mL de água; A solução eletrolítica hipertônica (SEHIPER) contendo 6g de NaCl; 1g de KCl; 3g de acetato de sódio; 15g de dextrose diluídos em 1.000mL de água. As soluções foram administradas na dose de 15mLkg-126h-1 durante 12 horas. Os tratamentos SEHIPO, SEISO e SEHIPER aumentaram a concentração plasmática de sódio, contudo apenas a SEHIPO não ocasionou alteração na osmolaridade sérica. As SEHIPO e SEISO aumentaram a volemia.