Armstrong Janis, Buchanan Elaine, Duncan Hazel, Ross Kathleen, Gerasimidis Konstantinos
Human Nutrition, School of Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow Royal Infirmary, Glasgow, UK.
Department of Dietetics, Royal Hospital for Sick Children, Glasgow, UK.
Arch Dis Child. 2017 Feb;102(2):152-156. doi: 10.1136/archdischild-2016-310971. Epub 2016 Sep 27.
There is an emerging interest in the use of blenderised food for tube-feeding (BFTF). This survey explored paediatric dietitians' perceptions and experiences of BFTF use.
A web-based questionnaire was distributed to the Paediatric group of the British Dietetic Association. The survey captured dietitians' personal opinions and experience supporting children on BFTF, and the perceptions of carers.
Of the 77 respondents, 19 were aware of professional guidelines and 63 had never received training on BFTF. Thirty-four would not recommend BFTF and 11 would advise against its use; yet 43 would recommend it to supplement commercial feeds. Fifty-seven would change their perception about BFTF if there were evidence-based guidelines. Forty-four would feel confident to support a patient using BFTF. Forty-three had previous experience supporting a patient with BFTF. The main concerns perceived by dietitians, pertinent to the use of BFTF, were nutritional inadequacy (n=71), tube blockages (n=64) and increased infection risk (n=59) but these were significantly higher than those experienced by themselves in clinical practice (p<0.001 for all three). A reduction in reflux and vomiting and increased carer involvement were the main perceived and observed benefits by both dietitians and carers.
The use of these feeds for tube-fed children is increasingly being seen as a viable choice. Dietitians experienced significantly fewer issues with the use of BFTF in clinical practice compared with their self-reported apprehensions in the survey. Well-controlled studies are now needed to objectively assess the benefits, risks, costs and practicality of BFTF.
使用匀浆食物进行管饲（BFTF）正逐渐受到关注。本调查探讨了儿科营养师对BFTF使用的看法和经验。
向英国饮食协会的儿科组发放了一份基于网络的问卷。该调查收集了营养师对支持儿童使用BFTF的个人意见和经验，以及护理人员的看法。
在77名受访者中，19人知晓专业指南，63人从未接受过BFTF相关培训。34人不推荐BFTF，11人建议不要使用；然而，43人会推荐其作为商业喂养的补充。如果有循证指南，57人会改变对BFTF的看法。44人会有信心支持患者使用BFTF。43人曾有过支持患者使用BFTF的经验。营养师认为与BFTF使用相关的主要问题是营养不足（n = 71）、管道堵塞（n = 64）和感染风险增加（n = 59），但这些问题显著高于他们在临床实践中的实际经历（三者均p < 0.001）。营养师和护理人员主要观察到的益处是反流和呕吐减少以及护理人员参与度增加。
这些食物用于管饲儿童越来越被视为一种可行的选择。与调查中自我报告的担忧相比，营养师在临床实践中使用BFTF时遇到的问题要少得多。现在需要进行严格控制的研究，以客观评估BFTF的益处、风险、成本和实用性。
