Di Paolo, G, Twomlow, E, Hanna, F, Farmer, A, Lancaster, J, Sim, J ORCID: https://orcid.org/0000-0002-1816-1676 and Roffe, C (2019) Continuous or intermittent? Which regiment of enteral nutrition is better for acute stroke patients? A systematic review and meta-analysis. Online Journal of Neurology and Brain Disorders, 3 (3). 247 - 255.

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Abstract

Background and purpose: Enteral nutrition via nasogastric tube in acute stroke patients with dysphagia is an important determinant of patient outcomes. It is unclear whether intermittent or continuous feeding is more efficacious. The aim of this review is to examine the current evidence comparing the effectiveness of intermittent versus continuous feeding in stroke patients in terms of nutritional status, gastrointestinal intolerance and other complications.

Methods: A systematic review of randomized controlled studies comparing intermittent with continuous nasogastric feeding in acute stroke patients was conducted in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Metaanalyses) guidance using predefined search terms. The search was conducted in MEDLINE and EMBASE up to 1st March 2019. Two independent reviewers assessed study quality using the Joanna Briggs Institute Critical Appraisal Tool. Meta-analyses were conducted, where appropriate, using a random-effects model to pool risk ratio with corresponding 95% CI.

Results: Three studies including a total of 184 patients were identified. All three were medium to low quality. The definition of intermittent enteral nutrition within each study varied considerably in terms of volume, rate and mode of delivery. Achievement of nutritional targets was the same for both feeding patterns in the one study it was reported. Only aspiration pneumonia and diarrhea were measured by all three studies. There was no significant difference in the incidence of aspiration pneumonia (RR 0.91, 95% CI 0.53-1.57, p=0.74, I2=50%) and diarrhea (RR 1.74, 95% CI 0.70-4.30, p=0.23, I2=42%) between the two patterns of feeding. Other outcomes including, vomiting, gastric retention, mortality, pre-albumin and nasogastric tube complications showed no significant differences.

Conclusion: There is very little and low-quality evidence to inform patterns of enteral feeding after stroke. The available evidence shows no significant difference in nutritional achievement and complications between intermittent and continuous nasogastric tube feeding in acute stroke patients.

Item Type: Article
Additional Information: The final version of this article and all relevant information regarding this article can be found at; https://lupinepublishers.com/neurology-brain-disorders-journal/fulltext/continuous-or-intermittent-which-regimen-of-enteral-nutrition-is-better-for-acute.ID.000163.php#
Subjects: Q Science > Q Science (General)
R Medicine > R Medicine (General)
R Medicine > RA Public aspects of medicine
R Medicine > RM Therapeutics. Pharmacology > RM930 Rehabilitation therapy
R Medicine > RZ Other systems of medicine
Divisions: Faculty of Medicine and Health Sciences > School of Pharmacy and Bioengineering
Depositing User: Symplectic
Date Deposited: 17 Jun 2020 14:33
Last Modified: 17 Jun 2020 14:33
URI: https://eprints.keele.ac.uk/id/eprint/8101

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