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Amaratunga H, Bostock K, Cunich M, Steffens D, Carey S. Systematic review of service improvements for home enteral tube feeding in adults. Nutr Clin Pract 2023; 38:329-339. [PMID: 35975316 DOI: 10.1002/ncp.10900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 06/28/2022] [Accepted: 07/16/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Patients receiving home enteral tube feeding (HETF) have a high risk of complications and readmission to hospital. This study aims to evaluate effectiveness of staff- and/or patient-focused service-improvement strategies on clinical, patient-reported, and economic outcomes for patients receiving HETF across adult settings. METHODS The search was conducted using MEDLINE, EMBASE, and CINAHL databases. Quality of studies were appraised using the Cochrane Collaboration Risk of Bias tool and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) assessment. RESULTS Eleven studies met the inclusion criteria. Pooled data found targeted HETF education with patients, carers, and staff significantly improved knowledge immediately after education and was sustained at 3-6 months. Multimodal interventions, including the formation of specialist HETF teams, significantly reduced complications such as infection, gastrostomy blockage, tube displacement, and feed intolerance but do not significantly reduce unplanned hospital encounters (outpatient clinic visits, hospitalizations, and emergency presentations). Owing to the high risk of bias in the included studies, there is low-quality evidence to support staff training, patient education, and dedicated HETF teams. CONCLUSION This review highlights the need for further quality research to allow higher-level evidence for determining the usefulness of interventions aimed at improving outcomes for patients receiving HETF. Future research needs to include greater assessment of quality of life, quantification of the value of interventions in economic terms, and use of translational research frameworks. However, effective staff and patient education programs, along with comprehensive multidisciplinary care, should be considered standard care until a larger research base is developed.
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Affiliation(s)
- Hasini Amaratunga
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Kimberley Bostock
- Department of Nutrition and Dietetics, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Michelle Cunich
- Sydney Health Economics Collaborative, Sydney Local Health District, Sydney, New South Wales, Australia.,Charles Perkins Centre, Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Daniel Steffens
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, New South Wales, Australia.,Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital (RPAH), Sydney, New South Wales, Australia
| | - Sharon Carey
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, New South Wales, Australia.,Department of Nutrition and Dietetics, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.,Institute of Academic Surgery, Royal Prince Alfred Hospital (RPAH), Sydney, New South Wales, Australia
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Enteral Nutrition: Based on the Combination of Nutrison Fibre and TPF-DM with A Marine Biological-Based Active Polysaccharide Preparation. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:6213716. [PMID: 35813412 PMCID: PMC9262530 DOI: 10.1155/2022/6213716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 06/01/2022] [Accepted: 06/08/2022] [Indexed: 11/17/2022]
Abstract
Good nutrition is essential for human growth, wound healing, and spiritual vitality. However, some individuals are unable to eat or experience gastrointestinal problems such as severe diarrhea, vomiting, gastric retention, and even gastrointestinal bleeding for a variety of causes. Therefore, it has important clinical significance to provide patients with required nutrients and maintain the integrity of the body’s tissues and organs through enteral nutrition. Based on this, this work uses a dual carrier of polylactic acid (PLA) and polyvinyl alcohol (PVA) to carry marine biopolysaccharides combined with sodium alginate (PSS) and successfully obtains the intestinal tract based on marine bioactive polysaccharides. Nutritional oral biological preparations (PSS-PLA/PVA) also cooperate with enteral nutritional suspension (diabetes) (TPF-DM) and Nutrison fibre to provide enteral nutritional support for critically ill patients. PSS-PLA/PVA has been shown in clinical studies to increase the effect of enteral nutrition support, the function of intestinal T lymphatic tissue, and the ability to control immunological function, indicating that it is worthy of further clinical development.
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Mooi NM, Ncama BP. Preparedness to implement national enteral nutritional therapy practice guidelines: An observational study of primary health care institutions in South Africa. Afr J Prim Health Care Fam Med 2021. [DOI: 10.4102/phcfm.v13i1.3056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Galindo CDO, Beux MR, da Costa RL, Uniat KC, Leobet J, Ferreira SMR, Medeiros CO, Schieferdecker MEM, Stangarlin-Fiori L. Home-Prepared Enteral Tube Feeding: Evaluation of Microbiological Contamination, Hygiene, and the Profile of the Food Handler. Nutr Clin Pract 2020; 36:704-717. [PMID: 32975879 DOI: 10.1002/ncp.10577] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 08/16/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Little is known about the risk to patients' health when using home-prepared enteral tube feeding. The objective of this study was to explore the differences in hygiene conditions and microbial load of different types of home-prepared enteral tube feeding and explore associations between those differences and food handlers' characteristics. METHODS We evaluated 96 enteral formulations, considering 3 types used by adult patients: homemade enteral preparations (HEPs), blended enteral preparations (BEPs), and commercial enteral formulas (CEFs). Enteral formulations were collected from homes and microbiologically analyzed. Hygiene criteria were assessed using a checklist, applied during the handling stages. The profile of the food handler was reviewed using a questionnaire. RESULTS 82.3% (79/96) exceeded acceptable bacterial counts, which was 10³ colony-forming units per gram for aerobic mesophilic microorganisms and for total coliforms (35 °C), Escherichia coli, Staphylococcus sp, and Staphylococcus coagulase-positive, if present in the enteral formulations. The number of inadequate samples was higher in HEPs and BEPs than in CEFs. Considering the hygiene criteria, the home-prepared enteral tube feedings did not differ significantly. There was a significant difference among hygiene conditions considering the variables "monthly family income" and "food training." CONCLUSION Regardless of the type of enteral formulations used by patients, when handled at home, there was a risk of contamination. However, contaminants present in enteral formulations can be easily controlled with improvements in hygiene measures as well as with greater guidance and control during the handling stages.
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Affiliation(s)
| | - Marcia Regina Beux
- Graduate Program in Food and Nutrition, Federal University of Paraná, Curitiba, Paraná, Brazil
| | - Rayane Luizi da Costa
- Graduate Program in Food and Nutrition, Federal University of Paraná, Curitiba, Paraná, Brazil
| | - Kelly Cristina Uniat
- Department of Nutrition, Health Sciences Sector, Federal University of Paraná, Curitiba, Paraná, Brazil
| | - Jaqueline Leobet
- Department of Nutrition, Health Sciences Sector, Federal University of Paraná, Curitiba, Paraná, Brazil
| | | | - Caroline Opolski Medeiros
- Department of Nutrition, Health Sciences Sector, Federal University of Paraná, Curitiba, Paraná, Brazil
| | | | - Lize Stangarlin-Fiori
- Department of Nutrition, Health Sciences Sector, Federal University of Paraná, Curitiba, Paraná, Brazil
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The Effect of Enteral Tube Feeding on Patients' Health-Related Quality of Life: A Systematic Review. Nutrients 2019; 11:nu11051046. [PMID: 31083338 PMCID: PMC6566785 DOI: 10.3390/nu11051046] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 05/06/2019] [Accepted: 05/07/2019] [Indexed: 12/28/2022] Open
Abstract
Patients with functional gastrointestinal tract who are unable to meet their nutritional requirements may benefit from the use of enteral nutrition via feeding tubes which could be nasogastric, percutaneous endoscopic gastrostomy and jejunostomy. Although enteral tube feeding has been shown to promote nutritional status, improve wound healing, and enhance patients’ quality of life (QoL), evidence of tube and feed complications and reduced QoL has also been reported. Despite the increasing prevalence of patients on enteral tube feeding, no systematic review examining the role of enteral tube feeding on patients’ QoL appears to have been published. Aim: The aim of this systematic review is to evaluate the effect of enteral tube feeding on patients’ QoL. Method: Three databases (EMBASE, Pubmed, and PsycINFO) plus Google Scholar were searched for relevant articles based on the Population, Intervention, Comparator, Outcomes (PICO) framework. The review was in line with preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines and involved the use of synonyms and medical subject headings. In addition, search terms were combined using Boolean operators (AND/OR) and all the articles retrieved were exported to EndNote for de-duplication. Results: Fourteen articles which met the criteria were included and three distinct areas were identified: the effect of early versus late enteral tube feeding on QoL; the QoL of patients on gastrostomy versus standard care, and the effect of enteral tube feeding on QoL. Overall, nine studies reported improvement in the QoL of patients on enteral tube feeding, while five studies demonstrated either no significant difference or reduction in QoL. Some factors which may have influenced these outcomes are differences in types of gastrostomy tubes, enteral feeding methods (including time patients spent connected to enteral feed/pump), and patients’ medical conditions, as well as the generic and/or type of QoL measuring instrument used. Conclusion: Most reviewed studies suggest that enteral tube feeding is effective in improving patients’ QoL. The use of enteral tube feeding-specific QoL measuring instruments is recommended for future research, and improved management strategies including use of mobile enteral feeding pumps should further enhance patients’ QoL. More studies on the effect of delivery systems/enteral feeding pumps on QoL are needed as research in this area is limited.
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ÇELEBİ D, YILMAZ E. Cerrahi Hastalarda Enteral ve Parenteral Beslenmede Kanıta Dayalı Uygulamalar ve Hemşirelik Bakımı. İSTANBUL GELIŞIM ÜNIVERSITESI SAĞLIK BILIMLERI DERGISI 2019. [DOI: 10.38079/igusabder.546979] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
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Zhao Q, Li Y, Yu B, Yang P, Fan L, Tan B, Tian Y. Effects of Preoperative Enteral Nutrition on Postoperative Recent Nutritional Status in Patients with Siewert II and III Adenocarcinoma of Esophagogastric Junction after Neoadjuvant Chemoradiotherapy. Nutr Cancer 2018; 70:895-903. [PMID: 30273016 DOI: 10.1080/01635581.2018.1490780] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Qun Zhao
- Third Department of Surgery, The Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang, PR China
| | - Yong Li
- Third Department of Surgery, The Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang, PR China
| | - Bin Yu
- Third Department of Surgery, The Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang, PR China
| | - Peigang Yang
- Third Department of Surgery, The Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang, PR China
| | - Liqiao Fan
- Third Department of Surgery, The Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang, PR China
| | - Bibo Tan
- Third Department of Surgery, The Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang, PR China
| | - Yuan Tian
- Third Department of Surgery, The Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang, PR China
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Li Y, Ye Y, Mei Y, Ruan H, Yu Y. Semi-automated ultrasound guidance applied to nasogastrojejunal tube replacement for enteral nutrition in critically ill adults. Biomed Eng Online 2018; 17:21. [PMID: 29415733 PMCID: PMC5803918 DOI: 10.1186/s12938-018-0452-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 01/27/2018] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND AND OBJECTIVE At present, the enteral nutrition approaches via nose and duodenum (or nose and jejunum) are the preferred method of nutritional support in the medical engineering field, given the superiority of in line with physiological processes and no serious complication. In this study, the authors adopted saline as the acoustic window, and gave enteral nutrition support to critically ill patients, via the nasogastrojejunal approach guided by semi-automated ultrasound. These above patients benefited a lot from this kind of nutrition support treatment, and we aimed to report the detailed information. METHODS Critically ill patients (n = 41) who had been treated with hospitalized intestine nutrition were identified. The Apogee 1200 ultrasonic diagnostic apparatus, and nasogastrojejunal tubes were adopted to carry out intestine nutrition treatment guided by semi-automated ultrasound. In order to confirm the specific positions of cardia, gastric body, antrum of stomach, and pylorus, the semi-automated ultrasound was utilized to probe the stomach cavity. And then, the ultrasonic probe was placed in the cardia location, and the nasogastrojejunal tube was slowly inserted through the metal thread. After operation, the nursing service satisfaction of patients and mean operation time were calculated, respectively. RESULTS All the patients were treated with enteral nutrition via nasogastrojejunal tube, and the whole procedure was under the guidance of semi-automated ultrasonography. The end of the feeding tube is attached to the surface of the stomach with a greater curvature, which can be bent on account of a no gastric peristalsis squeeze function, and thereby were prevented from entering into the antrum and pylorus locations. After this procedure, the mental thread was taken out, and the tube was pushed forward by a "drift" approach in order to allow it to enter into the intestine. The total nursing service satisfaction of patients was 90.24%, and the total incidence of adverse reactions was 17.07%. CONCLUSIONS In summary, the application of saline can be taken as sound window, and the metal wire as the tracking target, the bedside nasogastrojejunal tube guided by semi-automated ultrasound is an effective feeding tube placement method, with relatively good clinical application value in medical engineering.
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Affiliation(s)
- Ying Li
- Department of Critical Care Medicine, Second People’s Hospital of Shenzhen, Shenzhen, 518035 People’s Republic of China
| | - Yu Ye
- Department of Neurosurgery, Longgang Central Hospital of Shenzhen, Shenzhen, 518116 People’s Republic of China
| | - Yang Mei
- Department of Critical Care Medicine, Second People’s Hospital of Shenzhen, Shenzhen, 518035 People’s Republic of China
| | - Haiying Ruan
- Department of Critical Care Medicine, Second People’s Hospital of Shenzhen, Shenzhen, 518035 People’s Republic of China
| | - Yuan Yu
- Department of Critical Care Medicine, Second People’s Hospital of Shenzhen, Shenzhen, 518035 People’s Republic of China
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Hvas CL, Farrer K, Blackett B, Lloyd H, Paine P, Lal S. Reduced 30-day gastrostomy placement mortality following the introduction of a multidisciplinary nutrition support team: a cohort study. J Hum Nutr Diet 2017; 31:413-421. [DOI: 10.1111/jhn.12520] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- C. L. Hvas
- Department of Hepatology and Gastroenterology; Aarhus University Hospital; Aarhus C Denmark
- Intestinal Failure Unit; Salford Royal NHS Foundation Trust; Mancheter UK
| | - K. Farrer
- Intestinal Failure Unit; Salford Royal NHS Foundation Trust; Mancheter UK
| | - B. Blackett
- Nutrition Support Team; Salford Royal NHS Foundation Trust; Manchester UK
| | - H. Lloyd
- Nutrition Support Team; Salford Royal NHS Foundation Trust; Manchester UK
| | - P. Paine
- Department of Gastroenterology; Salford Royal NHS Foundation Trust; Manchester UK
- The University of Manchester; Manchester UK
| | - S. Lal
- Intestinal Failure Unit; Salford Royal NHS Foundation Trust; Mancheter UK
- The University of Manchester; Manchester UK
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Affiliation(s)
- Omorogieva Ojo
- Senior Lecturer, Department of Adult Nursing and Paramedic Science, University of Greenwich
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