Table 5.13 Types of Enteral Feeding for Nutritional Management Post ABI
Author Year Country Research Design PEDro Sample Size |
Methods |
Outcomes |
Kostadima et al. (2005) Greece RCT PEDro=6 N=41 |
Population: Stroke=25, Head Injury=16; Mean Ag=47.3yr; Gender: Male=32, Female=9. Intervention: Ventilator dependant patients received either a gastrostomy or nasogastric tube for enteral feeding. Tubes were inserted within 24 hr of intubation. Patients were followed for 3wk. Outcome Measures: Pneumonia rates, Length of Stay (LOS) in intensive care unit, ventilation days, mortality. |
1. At the end of wk 2 and 3 the cumulative incidence of pneumonia was significantly higher in the nasogastric, compared to the gastrostomy group (p<0.05). 2. At the end of the first week the incidence of pneumonia was higher in the gastrostomy group although the result was not statistically significant. 3. No significant difference between groups in LOS, ventilation days, or mortality rates were found. |
(2018) USA Case Control N = 500 |
Population: Preselective Group (N=257): Mean Age= 50±21y; Gender: Male=71%, Female=29%; Mean Time Post Injury= within 24 hours; Mean GCS=10±5. Postselective Group (N=244): Mean age= 51±21; Gender: Male=78%, Female=22%; Mean Time Post Injury= within 24 hours; Mean GCS= 9±5. Intervention: Retrospective review of patients on an intensive care unit before and after a Surgical Feeding Tube (SFT) placement strategy was implemented in 2011. Patients before 2011 (2007 – 2010) were placed in the preselective group, and patients from 2012-2016 were placed in the postselective group. Outcome Measures: Percentage of unnecessary SFT placements, predictors of necessary SFT placement, and overall complication rates. |
1. The percentage of unnecessary SFTs was significantly different between groups (p<0.0001) showing a decrease from 25% preselective to 8% postselective. 2. Significant predictors of necessary SFT placement were: increasing age (p<0.0001), head injury (p<0.0001), cervical spinal cord injury (p<0.0109), and need for tracheostomy (p<0.0001). 3. Overall complication rate was not significantly different between the preselective and postselective groups (p=0.2574). |