Internal Medicine, Virginia Commonwealth University Health Systems, Richmond, Virginia, USA.
Allegheny Center for Digestive Health, Allegheny Health Network, Pittsburgh, Pennsylvania, USA.
Nutr Clin Pract. 2023 Dec;38(6):1247-1252. doi: 10.1002/ncp.11020. Epub 2023 May 25.
Enteral feeding plays a critical role in the management of hospitalized patients, especially in intensive care units. In addition to delivering important nutrients, it also maintains the integrity of the gut and microbiota. Enteral feeding is also associated with complications and adverse events, some are related to access placement, metabolic and electrolytes disturbances, and aspiration pneumonia. In tube-fed patients, aspiration pneumonia has a prevalence ranging from 4% to 95% with a mortality rate of 17%-62%. Our review has not showed any significant difference in the incidence of aspiration pneumonia between gastric and postpyloric feeding and, given the ease of gastric access, we therefore suggest using gastric feeding as an initial strategy for the delivery of nutrition unless postpyloric access is otherwise indicated for other clinical reasons.
肠内喂养在住院患者的治疗中起着至关重要的作用，尤其是在重症监护病房。它不仅提供重要的营养物质，还维持肠道和微生物群的完整性。肠内喂养也会引起并发症和不良事件，有些与置管、代谢和电解质紊乱以及吸入性肺炎有关。在接受管饲的患者中，吸入性肺炎的患病率为 4%至 95%，死亡率为 17%至 62%。我们的综述没有显示胃饲和幽门后喂养在吸入性肺炎发生率方面有任何显著差异，并且由于胃管置管较为容易，因此我们建议在没有其他临床原因需要幽门后置管的情况下，将胃饲作为营养输送的初始策略。
