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- Title
Equal aspiration rates in gastrically and transpylorically fed critically ill patients.
- Authors
Esparza, Jan; Boivin, Michel A.; Hartshorne, Michael F.; Levy, Howard; Esparza, J; Boivin, M A; Hartshorne, M F; Levy, H
- Abstract
<bold>Objectives: </bold>To determine the difference in aspiration rates between gastrically and transpylorically fed patients in the intensive care unit.<bold>Design: </bold>A prospective controlled study of critically ill patients randomized to receive either a gastrically placed feeding tube or a transpylorically placed feeding tube.<bold>Setting: </bold>University teaching hospital's medical intensive care unit. The study was conducted over 14 months.<bold>Patients: </bold>Fifty-four critically ill subjects (with an overall 40% mortality) with similar baseline age, severity of illness, and nutritional needs requiring enteral nutrition, with 51 completing the study.<bold>Interventions: </bold>All feeds were tagged with technetium-99m radiolabeled sulfur colloid, and the pulmonary secretions or lungs of each patient were scanned on a daily basis to determine whether aspiration had occurred. Patients were fed according to their assigned tube placement which was verified daily by continuous electromyography.<bold>Measurements and Results: </bold>Of 27 gastrically fed patients 2 (7%) had evidence of scanned feed in pulmonary secretions or the lung, compared to 3 of 24 (13%) transpylorically fed patients (n.s.). Clinical suspicion of aspiration was insensitive and detected only 60% of isotopically documented aspirations with a positive predictive value of 27%.<bold>Conclusion: </bold>There was no difference in aspiration rates between gastrically and transpylorically fed critically ill patients.
- Subjects
ASPIRATORS; INTENSIVE care units; CRITICALLY ill; CRITICAL care medicine; ELECTROMYOGRAPHY; COLLOIDS; RESPIRATORY organs; TEACHING hospitals
- Publication
Intensive Care Medicine, 2001, Vol 27, Issue 4, p660
- ISSN
0342-4642
- Publication type
journal article
- DOI
10.1007/s001340100880