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.	Kolaček 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, 张东云, 朱峥嵘.两种鼻饲法对重型颅脑损伤患者早期肠内营养并发症的影响.郧阳医学院学报, 2007, 26(3):156-157.
9.	黎琼, 李锦.改良鼻饲法在机械通气患者肠内营养中的应用.国际护理学杂志, 2009, 28(6):803-805.
10.	张玉兰.两种鼻饲肠内营养法治疗重型颅脑损伤患者并发症的比较观察.安徽医学, 2009, 30(9):1105-1106.
11.	张秀兰, 张丽英, 许伟芳.不同鼻饲法预防吸入性肺炎发生的效果观察.肠外与肠内营养, 2010, 17(4):253-254.
12.	秦秀凤.脑卒中鼻饲患者不同鼻饲法与并发症的关系.中国基层医药, 2010, 17(6):783.
13.	刘旺梅, 陈华英.营养泵在危重症患者中的应用.中国实用医药, 2011, 6(36):191-19.
14.	刘伟盛, 伍方红, 余苏琼. ICU老年危重病患者不同鼻饲方式肠内营养相关性腹泻发生率的比较.现代医药卫生, 2009, 25(3):395.
15.	王燕翔.肠内营养泵在脑卒中患者中的应用.内蒙古中医药, 2012, 31(7):57.
16.	柳继, 谈莉君, 桑征, 等.肠内营养不同灌注方式的效果评价.上海护理, 2012, 12(4):44-45.
17.	黄瑞英, 朱小燕, 王妤.持续泵入鼻饲与间歇鼻饲两种方法并发症的观察.广东医学, 2012, 33(10):1524-1525.
18.	李扬.应用输液泵鼻饲在急性脑卒中患者的效果观察.内蒙古中医药, 2012, 31(23):26-27.
19.	胡亮华.肠内营养泵用于预防呼吸机相关性肺炎的临床观察.实用临床医学, 2012, 13(10):53-54.
20.	范雪梅.肠内营养泵与注射器推注法行鼻饲肠内营养应用的比较.福建医药杂志, 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, 雷泽华, 胡伟明, 等.胰十二指肠切除术后早期应用肠内营养的系统评价.中国循证医学杂志, 2011, 11(10):1166-1171.
27.	左艳艳, 康焰.全胃肠外营养和肠内营养对重症急性胰腺炎患者预后影响的Meta分析.中国循证医学杂志, 2011, 11(11):1295-1301.
28.	刁骧.肠内营养对克隆氏病患者有益.中国循证医学杂志, 2007, 7(11):769.
29.	李卡, 杨婕.不同途径营养支持对结直肠癌术后患者免疫功能的影响.中国循证医学杂志, 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. Kolaček 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, 张东云, 朱峥嵘.两种鼻饲法对重型颅脑损伤患者早期肠内营养并发症的影响.郧阳医学院学报, 2007, 26(3):156-157.
9. 黎琼, 李锦.改良鼻饲法在机械通气患者肠内营养中的应用.国际护理学杂志, 2009, 28(6):803-805.
10. 张玉兰.两种鼻饲肠内营养法治疗重型颅脑损伤患者并发症的比较观察.安徽医学, 2009, 30(9):1105-1106.
11. 张秀兰, 张丽英, 许伟芳.不同鼻饲法预防吸入性肺炎发生的效果观察.肠外与肠内营养, 2010, 17(4):253-254.
12. 秦秀凤.脑卒中鼻饲患者不同鼻饲法与并发症的关系.中国基层医药, 2010, 17(6):783.
13. 刘旺梅, 陈华英.营养泵在危重症患者中的应用.中国实用医药, 2011, 6(36):191-19.
14. 刘伟盛, 伍方红, 余苏琼. ICU老年危重病患者不同鼻饲方式肠内营养相关性腹泻发生率的比较.现代医药卫生, 2009, 25(3):395.
15. 王燕翔.肠内营养泵在脑卒中患者中的应用.内蒙古中医药, 2012, 31(7):57.
16. 柳继, 谈莉君, 桑征, 等.肠内营养不同灌注方式的效果评价.上海护理, 2012, 12(4):44-45.
17. 黄瑞英, 朱小燕, 王妤.持续泵入鼻饲与间歇鼻饲两种方法并发症的观察.广东医学, 2012, 33(10):1524-1525.
18. 李扬.应用输液泵鼻饲在急性脑卒中患者的效果观察.内蒙古中医药, 2012, 31(23):26-27.
19. 胡亮华.肠内营养泵用于预防呼吸机相关性肺炎的临床观察.实用临床医学, 2012, 13(10):53-54.
20. 范雪梅.肠内营养泵与注射器推注法行鼻饲肠内营养应用的比较.福建医药杂志, 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, 雷泽华, 胡伟明, 等.胰十二指肠切除术后早期应用肠内营养的系统评价.中国循证医学杂志, 2011, 11(10):1166-1171.
27. 左艳艳, 康焰.全胃肠外营养和肠内营养对重症急性胰腺炎患者预后影响的Meta分析.中国循证医学杂志, 2011, 11(11):1295-1301.
28. 刁骧.肠内营养对克隆氏病患者有益.中国循证医学杂志, 2007, 7(11):769.
29. 李卡, 杨婕.不同途径营养支持对结直肠癌术后患者免疫功能的影响.中国循证医学杂志, 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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