Is looped nasogastric tube feeding more effective than conventional nasogastric tube feeding for dysphagia in acute stroke?
Open accessAbstract
BACKGROUND: Dysphagia occurs in up to 50% of patients admitted to hospital with acute strokes with up to 27% remaining by seven days. Up to 8% continue to have swallowing problems six months after their stroke with 1.7% still requiring enteral feeding. Nasogastric tubes (NGT) are the most commonly used method for providing enteral nutrition in early stroke, however they are easily and frequently removed leading to inadequate nutrition, early PEG (Percutaneous Endoscopic Gastrostomy) insertion or abandoning of feeding attempts. Looped nasogastric tube feeding may improve the delivery of nutrition to such patients. METHODS: Three centre, two arm randomised controlled trial, with 50 participants in each arm comparing loop (the intervention) versus conventional nasogastric tube feeding. The primary outcome measure is proportion of intended feed delivered in the first 2 weeks. The study is designed to show a mean increase of feed delivery of 16% in the intervention group as compared with the control group, with 90% power at a 5% significance level. Secondary outcomes are treatment failures, mean volume of feed received, adverse events, cost-effectiveness, number of chest x-rays, number of nasogastric tubes and tolerability. TRIAL REGISTRATION: ISRCTN Number: ISRCTN61174381.
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Two studies on nasal loops in tube-fed stroke patients demonstrated that nasal loops are safe, well-tolerated and effective in delivering full enteral nutrition.
“Two studies on nasal loops in tube-fed stroke patients demonstrated that nasal loops are safe, well-tolerated and effective in delivering full EN (167-169).”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [168]
The Background (page not provided) says early reports suggest nasal loops secure tubes and may allow more reliable feeding without compromising patient acceptability. But this paper is a trial protocol: its Abstract Methods lists feed delivery, adverse events and tolerability as outcomes to be measured, not findings. It does not demonstrate safety, good tolerability or delivery of full enteral nutrition. (LLM, conf=0.86)
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Cites
Protein and energy supplementation in elderly people at risk from malnutrition
Milne, A. C., Potter, J., Vivanti, A., & Avenell, A. (2009) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003288.pub3 · Cited by 849 · see citing works
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ESPEN practical guideline: Clinical nutrition and hydration in geriatrics
Volkert, D., Beck, A. M., Cederholm, T., Cruz-Jentoft, A., Hooper, L., Kiesswetter, E., Maggio, M., Raynaud-Simon, A., Sieber, C., Sobotka, L., et al. (2022) · Clinical Nutrition · doi:10.1016/j.clnu.2022.01.024 · Cited by 516 · see citing works
- Authors
- Beavan, J. R., Conroy, S., Leonardi-Bee, J., Bowling, T., Gaynor, C., Gladman, J., Good, D., Gorman, P., Harwood, R., Riley, J., Sach, T., & Sunman, W.
- Affiliations
- University of Nottingham (GB)
- Nottingham University Hospitals NHS Trust (GB)
- Royal Derby Hospital (GB)
- Corresponding author
- Beavan, Jessica R
- Venue
- Trials
- Published
- 2007-08-03
- Volume
- 8
- Issue
- 1
- Pages
- 19-19
- ISSN
- 1745-6215 (ISSN-L)
- PMC
- PMC1976319
- OpenAlex
- W1967081659
- Cited by
- 9
- References
- 1
- Citations by year
- 2026: 1 · 2025: 1 · 2022: 2 · 2020: 1 · 2018: 1 · 2015: 1 · 2014: 1
- FWCI
- 0.95
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Trials (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- ePrints Soton (University of Southampton) (acceptedVersion)
- Repository@Nottingham (University of Nottingham) (submittedVersion, other-oa)
- Repository@Nottingham (University of Nottingham) (submittedVersion, cc-by)
- UEA Digital Repository (University of East Anglia) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- University of Nottingham
- Topics
- Health Sciences › Health Professions › Speech and Hearing › Dysphagia Assessment and Management
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Keywords
- nasogastric tube feeding, dysphagia, acute stroke, enteral nutrition, feed delivery, percutaneous endoscopic gastrostomy, feeding tube removal, nutritional support
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