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

Beavan, Jessica; Paul Conroy, Simon; Harwood, Rowan; Gladman, John R.F.; Leonardi-Bee, Jo; Sach, Tracey; Bowling, Tim; Sunman, Wayne; Gaynor, Catherine

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 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.

Citation

Beavan, J., Paul Conroy, S., Harwood, R., Gladman, J. R., Leonardi-Bee, J., Sach, T., Bowling, T., Sunman, W., & Gaynor, C. (2010). Does looped nasogastric tube feeding improve nutritional delivery for patients with dysphagia after acute stroke? A randomised controlled trial. Age and Ageing, 39(5), 624-630. https://doi.org/10.1093/ageing/afq088

• Journal Article Type: Article
• Acceptance Date: Apr 28, 2010
• Online Publication Date: Jul 27, 2010
• Publication Date: 2010-09
• Deposit Date: Nov 19, 2024
• Publicly Available Date: Nov 20, 2024
• Journal: Age and Ageing
• Print ISSN: 0002-0729
• Electronic ISSN: 1468-2834
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Volume: 39
• Issue: 5
• Pages: 624-630
• DOI: https://doi.org/10.1093/ageing/afq088
• Public URL: https://nottingham-repository.worktribe.com/output/23533788
• Publisher URL: https://academic.oup.com/ageing/article/39/5/624/41459?login=false
• PMID: 20667840