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Comparison between Four Types of Long Term Tube Feeding Regarding Nutritional Effects, Complications and Outcomes

Received: 27 March 2015    Accepted: 3 April 2015    Published: 6 June 2015
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Abstract

Objective: to compare four types of long term tube feeding regarding nutritional effects, tube-related complications and outcome. Methods: retrospective study. Results: Mean BMI at time of tube insertion is 23.3, two years later 20.3 (P= 0.0312). Patients have follow up with HHC their mean BMI at base line is 23.5, after two years 21.53 (p =0.547). No difference regarding albumin, urea, sodium, potassium, hemoglobin over 6, 12, 24 months either patient has followed up with HHC or not. High creatinine level in 12 months with jejunostomy tube (p= 0.0270). There are no major complications among the patients. No minor complications within 48 h of tube insertion in 42.18%, No complications after 48 h of tube insertion in 36.05%.The mortality rate is 56.59%. Old age is associated with a higher mortality (p 0.0018) and survival is better for patients who have HHC follow up (p <0.0001).The commonest cause of death is aspiration pneumonia with septic shock and respiratory failure 37.68 % and PFG has the highest mortality rate. Conclusion: 1) Patients on long-term feeding tubes don’t gain weight. There is an urgent need to improve method of nutritional assessment and to have regular follow up to calculate their calories requirement and adjust their formula accordingly; 2) The nutritional status in four feeding tubes is similar except in12 months there is significant difference in creatinine in jejunostomy tube; 3) Rate of complications is low among our patients with reference to the long period of follow-up. Almost all complications have been mild and could be managed throughout adequately; 4) Tube related infection and leakage reported more in PFG. It could be because it is the commonest tube used among our patients.

Published in Science Journal of Clinical Medicine (Volume 4, Issue 3)
DOI 10.11648/j.sjcm.20150403.12
Page(s) 60-66
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Enteral Tube Feeding, Mortality, Percutaneous Fluoroscopic Gastrostomy, Gastro Jejunostomy, Complications, Percutaneous Endoscopic Gastrostomy

References
[1] Carucci LR, Evaluation of patients with jejunostomy tubes: imaging findings. Radiology. 2002 Apr;223(1):2417.
[2] Simon EJ Janes,. Percutaneous endoscopic gastrostomy: 30-day mortality trends and risk factors. Year: 2005, Volume: 51, Issue: 1, Page: 23-29
[3] Salem M. Bazarah, PERCUTANEOUS GASTROSTOMY AND GASTROJEJUNOSTOMY: RADIOLOGICAL AND ENDOSCOPIC APPROACH. Annals of Saudi Medicine, Vol 22, Nos 1 -2, 2002
[4] Arabi Y, Haddad S, The impact of implementing an enteral tube feeding protocol on caloric and protein delivery in intensive care unit patients. Nutr Clin Pract. 2004 Oct;19(5):523-30
[5] Hanaa Banjar. Gastrostomy Tube Feeding of Cystic Fibrosis Patients. Bahrain Medical Bulletin, Vol. 26, No. 4, March 2004
[6] Al Rawas M. Percutaneous Fluoroscopic Guided Gastrostomy 6-Years’ Experience in Jeddah,Saudi Arabia. Qatar Medical Journal, Volume 9, No. 2, Dec 2000, P55-57
[7] Park RH, Allison MC, Lang J, et al. Randomised comparison of percutaneous endoscopic gastrostomy and nasogastric tube feeding in patients with persisting neurological dysphagia. BMJ 1992;304:1406-9.
[8] Magne N, Marcy PY, Foa C, et al. Comparison between nasogastric tube feeding and percutaneous fluoroscopic gastrostomy in advanced head and neck cancer patients. Eur Arch Otorhinolaryngol. 2001;258:89–92.
[9] Baeten C, Hoefnagels J. Feeding via nasogastric tube or percutaneous endoscopic gastrostomy: a comparison. Scand J Gastroenterol Suppl. 1992;41:189.
[10] McClave, Enteral tube feeding in the intensive care unit: Factors impeding adequate delivery.Crit Care Med 1999; 27:1252-1256
[11] Ciocon JO, Silverstone FA, Graver LM, Foley CJ. Tube feedings in elderly patients. Indications, benefits, and complications. Arch Intern Med 1988; 148:429.
[12] Kaw M, Sekas G. Long-term follow-up of consequences of percutaneous endoscopic gastrostomy (PEG) tubes in nursing home patients. Dig Dis Sci 1994; 39:738.
[13] Dwolatzky T, Berezovski S, Friedmann R, Paz J .A prospective comparison of the use of nasogastric and percutaneous endoscopic gastrostomy tubes for long-term enteral feeding in older people.,Department of Geriatric Medicine, Shaare Zedek Medical Center, Jesuralem, Israel. Clin Nutr. 2001 Dec;20(6):535-40.
[14] Dwyer KM, Watts DD, Thurber JS, et al; Percutaneous endoscopic gastrostomy: the preferred method of elective feeding tube placement in trauma patients. J Trauma. 2002 Jan;52(1):26-32
[15] Beaver ME Percutaneous fluoroscopic gastrostomy tube placement in patients with head and neck cancer. Arch Otolaryngol Head Neck Surg. 1998 Oct;124(10):1141-4
[16] Dwyer KM, Watts DD, Thurber JS, et al; Percutaneous endoscopic gastrostomy: the preferred method of elective feeding tube placement in trauma patients. J Trauma. 2002 Jan;52(1):26-32.
[17] Galaski A, Gastrostomy tube placement by radiological versus endoscopic methods in an acute care setting: A retrospective review of frequency, indications, complications and outcomes. Can J Gastroenterol. 2009 Feb;23(2):109-14.
[18] Ji Hoon Shin. Updates on Percutaneous Radiologic Gastrostomy/Gastrojejunostomy and Jejunostomy. Gut Liver. 2010 September; 4(Suppl. 1): S25–S31.
[19] Stoneham G, Pneumoperitoneum post-fluoroscopic percutaneous gastrojejunostomy insertion: computed tomography and clinical evaluation. Can Assoc Radiol J. 2012 Aug; 63(3 Suppl):S33-6.
[20] Finucane TE. Tube feeding in dementia: how incentives undermine health care quality and patient safety. J Am Med Dir Assoc. 2007 May;8(4):205-8. Epub 2007 Apr 18.
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    Muneerah Albugami, Yasmin Al Twaijri, Abeer Ibrahim, Habib Bassil, Ulrike Laudon, et al. (2015). Comparison between Four Types of Long Term Tube Feeding Regarding Nutritional Effects, Complications and Outcomes. Science Journal of Clinical Medicine, 4(3), 60-66. https://doi.org/10.11648/j.sjcm.20150403.12

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    ACS Style

    Muneerah Albugami; Yasmin Al Twaijri; Abeer Ibrahim; Habib Bassil; Ulrike Laudon, et al. Comparison between Four Types of Long Term Tube Feeding Regarding Nutritional Effects, Complications and Outcomes. Sci. J. Clin. Med. 2015, 4(3), 60-66. doi: 10.11648/j.sjcm.20150403.12

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    AMA Style

    Muneerah Albugami, Yasmin Al Twaijri, Abeer Ibrahim, Habib Bassil, Ulrike Laudon, et al. Comparison between Four Types of Long Term Tube Feeding Regarding Nutritional Effects, Complications and Outcomes. Sci J Clin Med. 2015;4(3):60-66. doi: 10.11648/j.sjcm.20150403.12

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  • @article{10.11648/j.sjcm.20150403.12,
      author = {Muneerah Albugami and Yasmin Al Twaijri and Abeer Ibrahim and Habib Bassil and Ulrike Laudon and Mohamed El Karouri and Abdulaziz Al Rashed and Abdelazeim Elamin and Ahmed Sabry and Rania Abdelreheem and Abdulwahab Motieb and Ali Al Araj and Reem Hawary and Sawsan Al Balawi},
      title = {Comparison between Four Types of Long Term Tube Feeding Regarding Nutritional Effects, Complications and Outcomes},
      journal = {Science Journal of Clinical Medicine},
      volume = {4},
      number = {3},
      pages = {60-66},
      doi = {10.11648/j.sjcm.20150403.12},
      url = {https://doi.org/10.11648/j.sjcm.20150403.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjcm.20150403.12},
      abstract = {Objective: to compare four types of long term tube feeding regarding nutritional effects, tube-related complications and outcome. Methods: retrospective study. Results: Mean BMI at time of tube insertion is 23.3, two years later 20.3 (P= 0.0312). Patients have follow up with HHC their mean BMI at base line is 23.5, after two years 21.53 (p =0.547). No difference regarding albumin, urea, sodium, potassium, hemoglobin over 6, 12, 24 months either patient has followed up with HHC or not. High creatinine level in 12 months with jejunostomy tube (p= 0.0270). There are no major complications among the patients. No minor complications within 48 h of tube insertion in 42.18%, No complications after 48 h of tube insertion in 36.05%.The mortality rate is 56.59%. Old age is associated with a higher mortality (p 0.0018) and survival is better for patients who have HHC follow up (p <0.0001).The commonest cause of death is aspiration pneumonia with septic shock and respiratory failure 37.68 % and PFG has the highest mortality rate. Conclusion: 1) Patients on long-term feeding tubes don’t gain weight. There is an urgent need to improve method of nutritional assessment and to have regular follow up to calculate their calories requirement and adjust their formula accordingly; 2) The nutritional status in four feeding tubes is similar except in12 months there is significant difference in creatinine in jejunostomy tube; 3) Rate of complications is low among our patients with reference to the long period of follow-up. Almost all complications have been mild and could be managed throughout adequately; 4) Tube related infection and leakage reported more in PFG. It could be because it is the commonest tube used among our patients.},
     year = {2015}
    }
    

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  • TY  - JOUR
    T1  - Comparison between Four Types of Long Term Tube Feeding Regarding Nutritional Effects, Complications and Outcomes
    AU  - Muneerah Albugami
    AU  - Yasmin Al Twaijri
    AU  - Abeer Ibrahim
    AU  - Habib Bassil
    AU  - Ulrike Laudon
    AU  - Mohamed El Karouri
    AU  - Abdulaziz Al Rashed
    AU  - Abdelazeim Elamin
    AU  - Ahmed Sabry
    AU  - Rania Abdelreheem
    AU  - Abdulwahab Motieb
    AU  - Ali Al Araj
    AU  - Reem Hawary
    AU  - Sawsan Al Balawi
    Y1  - 2015/06/06
    PY  - 2015
    N1  - https://doi.org/10.11648/j.sjcm.20150403.12
    DO  - 10.11648/j.sjcm.20150403.12
    T2  - Science Journal of Clinical Medicine
    JF  - Science Journal of Clinical Medicine
    JO  - Science Journal of Clinical Medicine
    SP  - 60
    EP  - 66
    PB  - Science Publishing Group
    SN  - 2327-2732
    UR  - https://doi.org/10.11648/j.sjcm.20150403.12
    AB  - Objective: to compare four types of long term tube feeding regarding nutritional effects, tube-related complications and outcome. Methods: retrospective study. Results: Mean BMI at time of tube insertion is 23.3, two years later 20.3 (P= 0.0312). Patients have follow up with HHC their mean BMI at base line is 23.5, after two years 21.53 (p =0.547). No difference regarding albumin, urea, sodium, potassium, hemoglobin over 6, 12, 24 months either patient has followed up with HHC or not. High creatinine level in 12 months with jejunostomy tube (p= 0.0270). There are no major complications among the patients. No minor complications within 48 h of tube insertion in 42.18%, No complications after 48 h of tube insertion in 36.05%.The mortality rate is 56.59%. Old age is associated with a higher mortality (p 0.0018) and survival is better for patients who have HHC follow up (p <0.0001).The commonest cause of death is aspiration pneumonia with septic shock and respiratory failure 37.68 % and PFG has the highest mortality rate. Conclusion: 1) Patients on long-term feeding tubes don’t gain weight. There is an urgent need to improve method of nutritional assessment and to have regular follow up to calculate their calories requirement and adjust their formula accordingly; 2) The nutritional status in four feeding tubes is similar except in12 months there is significant difference in creatinine in jejunostomy tube; 3) Rate of complications is low among our patients with reference to the long period of follow-up. Almost all complications have been mild and could be managed throughout adequately; 4) Tube related infection and leakage reported more in PFG. It could be because it is the commonest tube used among our patients.
    VL  - 4
    IS  - 3
    ER  - 

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Author Information
  • Internal Medicine Department, King Faisal Specialist Hospital and Research Center, Riyadh, KSA

  • Research Center, King Faisal Specialist Hospital and Research Center, Riyadh, KSA

  • Internal Medicine Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt

  • Internal Medicine Department, King Faisal Specialist Hospital and Research Center, Riyadh, KSA

  • Internal Medicine Department, King Faisal Specialist Hospital and Research Center, Riyadh, KSA

  • Internal Medicine Department, King Faisal Specialist Hospital and Research Center, Riyadh, KSA

  • Internal Medicine Department, King Faisal Specialist Hospital and Research Center, Riyadh, KSA

  • Internal Medicine Department, King Faisal Specialist Hospital and Research Center, Riyadh, KSA

  • Internal Medicine Department, King Faisal Specialist Hospital and Research Center, Riyadh, KSA

  • Internal Medicine Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt

  • Internal Medicine Department, King Faisal Specialist Hospital and Research Center, Riyadh, KSA

  • Internal Medicine Department, King Faisal Specialist Hospital and Research Center, Riyadh, KSA

  • Nutrition Services, King Faisal Specialist Hospital and Research Center, Riyadh, KSA

  • Nutrition Services, King Faisal Specialist Hospital and Research Center, Riyadh, KSA

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