Gastric versus post-pyloric feeding: a systematic review.
Gastric versus post-pyloric feeding: a systematic review.
复制标题
DOI：
10.1186/cc2190
复制
发表时间：
2003-06
期刊：
影响因子：
--
通讯作者：
Zaloga GP
中科院分区：
文献类型：
--
作者：
Marik PE;Zaloga GP
我们的目的是评价胃与幽门后喂养对重症和创伤ICU患者肺炎发生率、热量摄入、ICU住院时间（LOS）和死亡率的影响。数据来源为Medline、Embase、Healthstar、相关主要和综述文章的引文综述、个人档案以及与专家线人的联系。在筛选的122篇文章中，9篇被确定为前瞻性随机对照试验（共包括522例患者），比较了胃与幽门后喂养，并被纳入数据提取。描述性和结局数据由两位评审员独立从论文中提取。主要观察指标为医院获得性肺炎的发生率、达到的平均热量目标、平均每日热量摄入、开始管饲的时间、达到目标的时间、ICU LOS和死亡率。采用随机效应模型进行荟萃分析。仅内科、神经外科和创伤患者入组分析研究。在肺炎的发生率、达到热量目标的百分比、平均总热量摄入、ICU LOS或死亡率方面，胃饲组和幽门后喂养组之间没有显著差异。随机接受胃饲的患者开始肠内营养的时间显著缩短。然而，达到热量目标的时间在两组之间没有差异。在这项荟萃分析中，我们无法证明在包括内科、神经外科和创伤ICU患者在内的混合组危重患者中，幽门后喂养与胃管喂养的临床获益。两组的肺炎、ICU LOS和死亡率相似。由于幽门后插管的延迟，胃饲的开始明显早于幽门后饲。本研究虽然提供了关于肠内营养途径的最佳证据，但总样本量较小。
Our objective was to evaluate the impact of gastric versus post-pyloric feeding on the incidence of pneumonia, caloric intake, intensive care unit (ICU) length of stay (LOS), and mortality in critically ill and injured ICU patients. Data sources were Medline, Embase, Healthstar, citation review of relevant primary and review articles, personal files, and contact with expert informants. From 122 articles screened, nine were identified as prospective randomized controlled trials (including a total of 522 patients) that compared gastric with post-pyloric feeding, and were included for data extraction. Descriptive and outcomes data were extracted from the papers by the two reviewers independently. Main outcome measures were the incidence of nosocomial pneumonia, average caloric goal achieved, average daily caloric intake, time to the initiation of tube feeds, time to goal, ICU LOS, and mortality. The meta-analysis was performed using the random effects model. Only medical, neurosurgical and trauma patents were enrolled in the studies analyzed. There were no significant differences in the incidence of pneumonia, percentage of caloric goal achieved, mean total caloric intake, ICU LOS, or mortality between gastric and post-pyloric feeding groups. The time to initiation of enteral nutrition was significantly less in those patients randomized to gastric feeding. However, time to reach caloric goal did not differ between groups. In this meta-analysis we were unable to demonstrate a clinical benefit from post-pyloric versus gastric tube feeding in a mixed group of critically ill patients, including medical, neurosurgical, and trauma ICU patients. The incidences of pneumonia, ICU LOS, and mortality were similar between groups. Because of the delay in achieving post-pyloric intubation, gastric feeding was initiated significantly sooner than was post-pyloric feeding. The present study, while providing the best current evidence regarding routes of enteral nutrition, is limited by the small total sample size.
登录
查看更多内容
影响因子：
1.9
作者：
Beier-Holgersen, R;Brandstrup, B
通讯作者：
Brandstrup, B
影响因子：
8.8
作者：
GIANOTTI, L;ALEXANDER, JW;CHALK, CL
通讯作者：
CHALK, CL
DOI：
10.1164/ajrccm.154.6.8970354
发表时间：
1996-12-01
影响因子：
24.7
作者：
Heyland, DK;Tougas, G;Guyatt, GH
通讯作者：
Guyatt, GH
影响因子：
38.9
作者：
Jooste, CA;Mustoe, J;Collee, G
通讯作者：
Collee, G
影响因子：
--
作者：
Lewis, SJ;Egger, M;Thomas, S
通讯作者：
Thomas, S