Department of Medicine & Geriatrics, Shatin Hospital, Hong Kong SAR, China.
Clin Nutr. 2010 Aug;29(4):453-8. doi: 10.1016/j.clnu.2009.10.003. Epub 2009 Nov 12.
BACKGROUND & AIMS: Continuous pump feeding is often used to reduce aspiration risk in older patients on tube feeding, but its effectiveness in preventing aspiration pneumonia is unproven. A randomized controlled trial was therefore performed to examine the effectiveness of continuous pump feeding in decreasing the incidence of pneumonia in tube-fed older hospital patients.
One hundred and seventy eight elderly patients from three convalescence hospitals and one infirmary, on nasogastric tube feeding, were randomly assigned to have intermittent bolus (bolus) or continuous pump (pump) feeding for 4weeks. The primary outcome was the incidence of pneumonia. The secondary outcome was mortality.
Eighty five subjects were randomized into the pump group and 93 in the bolus group. The groups were comparable in age, nutritional and functional status, co-morbidities and history of pneumonia, except that there were more women in the pump group. Within 4weeks, 15 subjects (17.6%) in the pump group and 18 (19.4%) in the bolus group developed pneumonia. Seven subjects (8.2%) in pump group and 13 subjects (14.0%) in bolus group died. There was no significant difference in either pneumonia or death rates between the two groups.
Continuous pump feeding did not significantly affect the rates of pneumonia or mortality in tube-fed older hospital patients when compared with intermittent bolus feeding.
在接受管饲的老年患者中，常采用持续泵入的方式以降低吸入风险，但这种方法在预防吸入性肺炎方面的有效性尚未得到证实。因此，进行了一项随机对照试验，以检验持续泵入在降低管饲老年住院患者肺炎发生率方面的有效性。
将来自三家疗养院和一家护理院的 178 名接受鼻胃管喂养的老年患者随机分为间歇推注（推注）或持续泵入（泵入）组，进行 4 周的喂养。主要结局是肺炎的发生率。次要结局是死亡率。
85 名受试者被随机分配到泵入组，93 名受试者被分配到推注组。两组在年龄、营养和功能状态、合并症和肺炎史等方面具有可比性，除了泵入组中女性更多。在 4 周内，泵入组中有 15 名（17.6%）受试者和推注组中有 18 名（19.4%）受试者发生肺炎。泵入组中有 7 名（8.2%）受试者和推注组中有 13 名（14.0%）受试者死亡。两组间肺炎或死亡率均无显著差异。
与间歇推注喂养相比，持续泵入喂养并未显著影响管饲老年住院患者的肺炎或死亡率。
