Weston Sharon, Algotar Anushree, Karjoo Sara, Gabel Megan, Kruszewski Patrice, Duro Debora, Sankararaman Senthilkumar, Wendel Danielle, Namjoshi Shweta S, Abdelhadi Ruba A, Kawatu David, Corkins Mark R, Sentongo Timothy
Department of Clinical Nutrition, Boston Children's Hospital, Boston, Massachusetts, USA.
C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, Michigan, USA.
J Pediatr Gastroenterol Nutr. 2025 Aug;81(2):376-386. doi: 10.1002/jpn3.70048. Epub 2025 May 5.
This state-of-the-art review was produced by a multidisciplinary team composed of pediatric gastroenterology and nutrition healthcare providers to provide a comprehensive overview of the use of blenderized tube feeds (BTFs). The team developed 12 vital questions to address gaps in the current understanding and practice of using BTFs, then performed a comprehensive search of literature published between 2000 and 2023 using PubMed, MEDLINE, Embase databases, and an individual search of references. There was a scarcity of well-designed randomized clinical trials, and most of the studies were prospective or retrospective observational reports from heterogeneous patient demographics, varieties of BTFs, and medical conditions. Use of BTFs was associated with improved outcomes, including higher satisfaction, reduced gastroesophageal reflux, retching, gagging, constipation, frequency of hospitalization for respiratory disease, and greater diversity of the gut microbiome. However, homemade and commercially manufactured BTFs varied in nutrient composition and physical properties, such as viscosity, which posed challenges related to ease of administration and comparison of clinical outcomes. Therefore, whereas the use of BTFs as an alternative to standard commercial formulas has become increasingly popular, further evidence is warranted to provide guidelines on best practices for usage, monitoring, and comparing clinical outcomes. Pediatric dietitians and clinician practitioners must regularly monitor children receiving BTFs to ensure nutritional adequacy, optimize safe and effective delivery, and promote optimal growth. The team proposed future directions regarding best practices for using BTFs, primarily related to clinical application and nutritional outcomes in children and adolescents.
这篇前沿综述由一个多学科团队撰写,该团队由儿科胃肠病学和营养保健提供者组成,旨在全面概述匀浆管饲(BTF)的使用情况。该团队提出了12个关键问题,以解决当前在BTF使用理解和实践方面的差距,然后使用PubMed、MEDLINE、Embase数据库对2000年至2023年发表的文献进行了全面检索,并对参考文献进行了单独检索。缺乏设计良好的随机临床试验,大多数研究是来自不同患者人群、各种BTF和医疗状况的前瞻性或回顾性观察报告。使用BTF与改善结局相关,包括更高的满意度、减少胃食管反流、干呕、作呕、便秘、呼吸道疾病住院频率以及肠道微生物群的多样性增加。然而,自制和商业生产的BTF在营养成分和物理性质(如粘度)方面存在差异,这给给药便利性和临床结局比较带来了挑战。因此,尽管将BTF作为标准商业配方奶粉的替代品越来越受欢迎,但仍需要进一步的证据来提供关于使用、监测和比较临床结局的最佳实践指南。儿科营养师和临床医生必须定期监测接受BTF的儿童,以确保营养充足,优化安全有效的给药方式,并促进最佳生长。该团队提出了关于使用BTF最佳实践的未来方向,主要涉及儿童和青少年的临床应用和营养结局。