Effects of Enteral Feeding Pump and Intermittent Bolus Nasogastric Feeding on Reducing Complications of Enteral Nutrition: A Meta-Analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 YANGJian-guo ¹ ,  ZHANGJun ¹ , YANGBao-yi ² , FANGMin ³ , LVYi-jun ³

1. Wuhan University HOPE School of Nursing, Wuhan 430071, China;
2. Department of Nursing, Bengbu Medical College, Bengbu 233030, China;
3. Hubei University of Medicine Affiliated Taihe Hospital, Shiyan 442000, China;

Corresponding?author：

ZHANGJun, Email: catherinezhang2010@126.com

Keywords：

Enteral nutrition; Enteral feeding pump; Nasogastric feeding; Systematic review; Meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.20140035

Video：

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Objective To systematically review the effects of enteral feeding pump and intermittent bolus nasogastric feeding on gastric retention, diarrhea, regurgitation, and other complications of patients who received enteral nutrition treatment. Methods We electronically searched databases including PubMed (1980-2013.9), Wiley Online Library (1990-2013.9), Elsevier (1990-2013.9), CNKI (1990-2013.9), VIP (1989-2013.9) and WanFang Data (1990-2013.9), to collect randomized controlled trials (RCTs) about enteral feeding pump and intermittent bolus nasogastric feeding. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data, and assessed the methodological quality of the included studies, and then meta-analysis was performed using RevMan 5.2.6 software. Results A total of 16 trials involving 1 263 patients were finally included. The results of meta-analysis indicated that enteral feeding pump was better than intermittent bolus nasogastric feeding in the incidences of gastric retention (OR=0.27, 95%CI 0.16 to 0.45, P < 0.000 01), diarrhea (OR=0.24, 95%CI 0.16 to 0.34, P < 0.000 01), regurgitation (OR=0.26, 95%CI 0.11 to 0.65, P=0.004), aspiration (OR=0.19, 95%CI 0.11 to 0.32, P < 0.000 01), aspiration pneumonia (OR=0.40, 95%CI 0.23 to 0.68, P=0.000 7), and abdominal distension (OR=0.24, 95%CI 0.10 to 0.57, P=0.001), with significant differences. However, they were alike in the incidence of tub obstruction (OR=0.43, 95%CI 0.14 to 1.29, P=0.13). Conclusion According to existing relevant RCTs, enteral feeding pump is better than intermittent bolus nasogastric feeding in reducing enteral nutrition complications to some extent. However, due to the low methodological quality of the included studies, more large-scale, multicentre high quality RCTs are still needed to verify the aforementioned conclusion.

Citation： YANGJian-guo, ZHANGJun, YANGBao-yi, FANGMin, LVYi-jun. Effects of Enteral Feeding Pump and Intermittent Bolus Nasogastric Feeding on Reducing Complications of Enteral Nutrition: A Meta-Analysis. Chinese Journal of Evidence-Based Medicine, 2014, 14(2): 197-204. doi: 10.7507/1672-2531.20140035 Copy

1.	Seron-Arbeloa C, Zamora-Elson M, Labarta-Monzon L, et al. Enteral nutrition in critical care. J Clin Med Res, 2013, 5(1):1-11.
2.	Silva MA, Santos SG, Tomasi CD, et al. Enteral nutrition discontinuation and outcomes in general critically ill patients. Clinics, 2013, 68(2):173-178.
3.	Kola?ek S. Enteral nutrition. Evidence-Based Research in Pediatric Nutrition, 2013, 108:86-90.
4.	Higgins JPT, Altman DG, Sterne JAC(editors). Chapter 8:Assessing risk of bias in included studies. In:Higgins JPT, Green S(editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0(updated March 2011). The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org.
5.	Ciocon JO, Galindo-Ciocon DJ, Tiessen C, et al. Continuous compared with intermittent tube feeding in the elderly. JPEN J Parenter Enteral Nutr, 1992, 16(6):525-528.
6.	Serpa LF, Kimura M, Faintuch J, et al. Effects of continuous versus bolus infusion of enteral nutrition in critical patients. Rev Hosp Clin Fac Med Sao Paulo, 2003, 58(1):9-14.
7.	Lee JS, Kwok T, Chui PY, et al. Can continuous pump feeding reduce the incidence of pneumonia in nasogastric tube-fed patients? A randomized controlled trial. Clin Nutr, 2010, 29(4):453-458.
8.	李梅, 張東云, 朱崢嶸.兩種鼻飼法對重型顱腦損傷患者早期腸內營養并發癥的影響.鄖陽醫學院學報, 2007, 26(3):156-157.
9.	黎瓊, 李錦.改良鼻飼法在機械通氣患者腸內營養中的應用.國際護理學雜志, 2009, 28(6):803-805.
10.	張玉蘭.兩種鼻飼腸內營養法治療重型顱腦損傷患者并發癥的比較觀察.安徽醫學, 2009, 30(9):1105-1106.
11.	張秀蘭, 張麗英, 許偉芳.不同鼻飼法預防吸入性肺炎發生的效果觀察.腸外與腸內營養, 2010, 17(4):253-254.
12.	秦秀鳳.腦卒中鼻飼患者不同鼻飼法與并發癥的關系.中國基層醫藥, 2010, 17(6):783.
13.	劉旺梅, 陳華英.營養泵在危重癥患者中的應用.中國實用醫藥, 2011, 6(36):191-19.
14.	劉偉盛, 伍方紅, 余蘇瓊. ICU老年危重病患者不同鼻飼方式腸內營養相關性腹瀉發生率的比較.現代醫藥衛生, 2009, 25(3):395.
15.	王燕翔.腸內營養泵在腦卒中患者中的應用.內蒙古中醫藥, 2012, 31(7):57.
16.	柳繼, 談莉君, 桑征, 等.腸內營養不同灌注方式的效果評價.上海護理, 2012, 12(4):44-45.
17.	黃瑞英, 朱小燕, 王妤.持續泵入鼻飼與間歇鼻飼兩種方法并發癥的觀察.廣東醫學, 2012, 33(10):1524-1525.
18.	李揚.應用輸液泵鼻飼在急性腦卒中患者的效果觀察.內蒙古中醫藥, 2012, 31(23):26-27.
19.	胡亮華.腸內營養泵用于預防呼吸機相關性肺炎的臨床觀察.實用臨床醫學, 2012, 13(10):53-54.
20.	范雪梅.腸內營養泵與注射器推注法行鼻飼腸內營養應用的比較.福建醫藥雜志, 2013, 35(2):167-168.
21.	Rice TW, Swope T, Bozeman S, et al. Variation in enteral nutrition delivery in mechanically ventilated patients. Nutrition, 2005, 21(7-8):786-792.
22.	Heyland DK, Dhaliwal R, Drover JW, et al. Canadian clinical practice guidelines for nutrition support in mechanically ventilated, critically ill adult patients. JPEN J Parenter Enteral Nutr, 2003, 27(5):355-373.
23.	Araujo-Junqueira L, De-Souza DA. Enteral nutrition therapy for critically ill adult patients; critical review and algorithm creation. Nutr Hosp, 2012, 27(4):999-1008.
24.	Fernandez-Ortega JF, Herrero MJ, Martinez GP. Guidelines for specialized nutritional and metabolic support in the critically-ill patient:update. Consensus SEMICYUC-SENPE:indications, timing and routes of nutrient delivery. Nutr Hosp, 2011, 26(Suppl 2):7-11.
25.	Seron-Arbeloa C, Puzo-Foncillas J, Garces-Gimenez T, et al. A retrospective study about the influence of early nutritional support on mortality and nosocomial infection in the critical care setting. Clin Nutr, 2011, 30(3):346-350.
26.	高峰畏, 雷澤華, 胡偉明, 等.胰十二指腸切除術后早期應用腸內營養的系統評價.中國循證醫學雜志, 2011, 11(10):1166-1171.
27.	左艷艷, 康焰.全胃腸外營養和腸內營養對重癥急性胰腺炎患者預后影響的Meta分析.中國循證醫學雜志, 2011, 11(11):1295-1301.
28.	刁驤.腸內營養對克隆氏病患者有益.中國循證醫學雜志, 2007, 7(11):769.
29.	李卡, 楊婕.不同途徑營養支持對結直腸癌術后患者免疫功能的影響.中國循證醫學雜志, 2009, 9(12):1288-1291.

1. Seron-Arbeloa C, Zamora-Elson M, Labarta-Monzon L, et al. Enteral nutrition in critical care. J Clin Med Res, 2013, 5(1):1-11.
2. Silva MA, Santos SG, Tomasi CD, et al. Enteral nutrition discontinuation and outcomes in general critically ill patients. Clinics, 2013, 68(2):173-178.
3. Kola?ek S. Enteral nutrition. Evidence-Based Research in Pediatric Nutrition, 2013, 108:86-90.
4. Higgins JPT, Altman DG, Sterne JAC(editors). Chapter 8:Assessing risk of bias in included studies. In:Higgins JPT, Green S(editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0(updated March 2011). The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org.
5. Ciocon JO, Galindo-Ciocon DJ, Tiessen C, et al. Continuous compared with intermittent tube feeding in the elderly. JPEN J Parenter Enteral Nutr, 1992, 16(6):525-528.
6. Serpa LF, Kimura M, Faintuch J, et al. Effects of continuous versus bolus infusion of enteral nutrition in critical patients. Rev Hosp Clin Fac Med Sao Paulo, 2003, 58(1):9-14.
7. Lee JS, Kwok T, Chui PY, et al. Can continuous pump feeding reduce the incidence of pneumonia in nasogastric tube-fed patients? A randomized controlled trial. Clin Nutr, 2010, 29(4):453-458.
8. 李梅, 張東云, 朱崢嶸.兩種鼻飼法對重型顱腦損傷患者早期腸內營養并發癥的影響.鄖陽醫學院學報, 2007, 26(3):156-157.
9. 黎瓊, 李錦.改良鼻飼法在機械通氣患者腸內營養中的應用.國際護理學雜志, 2009, 28(6):803-805.
10. 張玉蘭.兩種鼻飼腸內營養法治療重型顱腦損傷患者并發癥的比較觀察.安徽醫學, 2009, 30(9):1105-1106.
11. 張秀蘭, 張麗英, 許偉芳.不同鼻飼法預防吸入性肺炎發生的效果觀察.腸外與腸內營養, 2010, 17(4):253-254.
12. 秦秀鳳.腦卒中鼻飼患者不同鼻飼法與并發癥的關系.中國基層醫藥, 2010, 17(6):783.
13. 劉旺梅, 陳華英.營養泵在危重癥患者中的應用.中國實用醫藥, 2011, 6(36):191-19.
14. 劉偉盛, 伍方紅, 余蘇瓊. ICU老年危重病患者不同鼻飼方式腸內營養相關性腹瀉發生率的比較.現代醫藥衛生, 2009, 25(3):395.
15. 王燕翔.腸內營養泵在腦卒中患者中的應用.內蒙古中醫藥, 2012, 31(7):57.
16. 柳繼, 談莉君, 桑征, 等.腸內營養不同灌注方式的效果評價.上海護理, 2012, 12(4):44-45.
17. 黃瑞英, 朱小燕, 王妤.持續泵入鼻飼與間歇鼻飼兩種方法并發癥的觀察.廣東醫學, 2012, 33(10):1524-1525.
18. 李揚.應用輸液泵鼻飼在急性腦卒中患者的效果觀察.內蒙古中醫藥, 2012, 31(23):26-27.
19. 胡亮華.腸內營養泵用于預防呼吸機相關性肺炎的臨床觀察.實用臨床醫學, 2012, 13(10):53-54.
20. 范雪梅.腸內營養泵與注射器推注法行鼻飼腸內營養應用的比較.福建醫藥雜志, 2013, 35(2):167-168.
21. Rice TW, Swope T, Bozeman S, et al. Variation in enteral nutrition delivery in mechanically ventilated patients. Nutrition, 2005, 21(7-8):786-792.
22. Heyland DK, Dhaliwal R, Drover JW, et al. Canadian clinical practice guidelines for nutrition support in mechanically ventilated, critically ill adult patients. JPEN J Parenter Enteral Nutr, 2003, 27(5):355-373.
23. Araujo-Junqueira L, De-Souza DA. Enteral nutrition therapy for critically ill adult patients; critical review and algorithm creation. Nutr Hosp, 2012, 27(4):999-1008.
24. Fernandez-Ortega JF, Herrero MJ, Martinez GP. Guidelines for specialized nutritional and metabolic support in the critically-ill patient:update. Consensus SEMICYUC-SENPE:indications, timing and routes of nutrient delivery. Nutr Hosp, 2011, 26(Suppl 2):7-11.
25. Seron-Arbeloa C, Puzo-Foncillas J, Garces-Gimenez T, et al. A retrospective study about the influence of early nutritional support on mortality and nosocomial infection in the critical care setting. Clin Nutr, 2011, 30(3):346-350.
26. 高峰畏, 雷澤華, 胡偉明, 等.胰十二指腸切除術后早期應用腸內營養的系統評價.中國循證醫學雜志, 2011, 11(10):1166-1171.
27. 左艷艷, 康焰.全胃腸外營養和腸內營養對重癥急性胰腺炎患者預后影響的Meta分析.中國循證醫學雜志, 2011, 11(11):1295-1301.
28. 刁驤.腸內營養對克隆氏病患者有益.中國循證醫學雜志, 2007, 7(11):769.
29. 李卡, 楊婕.不同途徑營養支持對結直腸癌術后患者免疫功能的影響.中國循證醫學雜志, 2009, 9(12):1288-1291.

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Effects of Enteral Feeding Pump and Intermittent Bolus Nasogastric Feeding on Reducing Complications of Enteral Nutrition: A Meta-Analysis

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