Does looped nasogastric tube feeding improve nutritional delivery for patients with dysphagia after acute stroke? A randomised controlled trial

Age Ageing. 2010 Sep;39(5):624-30. doi: 10.1093/ageing/afq088. Epub 2010 Jul 27.

Abstract

Background: nasogastric tube (NGT) feeding is commonly used after stroke, but its effectiveness is limited by frequent dislodgement.

Objective: the objective of the study was to evaluate looped NGT feeding in acute stroke patients with dysphagia.

Methods: this was a randomised controlled trial of 104 patients with acute stroke fed by NGT in three UK stroke units. NGT was secured using either a nasal loop (n = 51) or a conventional adhesive dressing (n = 53). The main outcome measure was the proportion of prescribed feed and fluids delivered via NGT in 2 weeks post-randomisation. Secondary outcomes were frequency of NGT insertions, treatment failure, tolerability, adverse events and costs at 2 weeks; mortality; length of hospital stay; residential status; and Barthel Index at 3 months.

Results: participants assigned to looped NGT feeding received a mean 17% (95% confidence interval 5-28%) more volume of feed and fluids, required fewer NGTs (median 1 vs 4), and had fewer electrolyte abnormalities than controls. There was more minor nasal trauma in the loop group. There were no differences in outcomes at 3 months. Looped NGT feeding cost 88 pounds sterling more per patient over 2 weeks than controls.

Conclusion: looped NGT feeding improves delivery of feed and fluids and reduces NGT reinsertion with little additional cost.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Aged
  • Aged, 80 and over
  • Aging
  • Bandages
  • Deglutition Disorders / economics
  • Deglutition Disorders / mortality
  • Deglutition Disorders / rehabilitation*
  • Enteral Nutrition / economics
  • Enteral Nutrition / methods*
  • Enteral Nutrition / statistics & numerical data
  • Female
  • Health Care Costs
  • Humans
  • Intubation, Gastrointestinal / economics
  • Intubation, Gastrointestinal / methods*
  • Intubation, Gastrointestinal / standards
  • Length of Stay / statistics & numerical data
  • Male
  • Nutrition Disorders / economics
  • Nutrition Disorders / mortality
  • Nutrition Disorders / prevention & control*
  • Stroke / economics
  • Stroke / mortality
  • Stroke Rehabilitation*
  • Treatment Outcome