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Published in: Critical Care 1/2010

01-02-2010 | Commentary

Feed the ICU patient 'gastric' first, and go post-pyloric only in case of failure

Authors: Mette M Berger, Ludivine Soguel

Published in: Critical Care | Issue 1/2010

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Abstract

In a randomised trial comparing early enteral feeding by gastric and post-pyloric routes, White and colleagues have shown that gastric feeding is possible and efficient in the vast majority of critically ill patients. But the authors' conclusion that gastric is equivalent to post-pyloric is true in only the least severe patients. Given the extra workload and costs, post-pyloric is now clearly indicated in case of gastric feeding failure.
Literature
1.
go back to reference White H, Sosnowski K, Tra K, Reeves A, Jones M: A randomised controlled comparison of early post-pyloric versus early gastric feeding to meet nutritional targets in ventilated intensive care patients. Crit Care. 2009, 13: R187-10.1186/cc8181.PubMedCentralCrossRefPubMed White H, Sosnowski K, Tra K, Reeves A, Jones M: A randomised controlled comparison of early post-pyloric versus early gastric feeding to meet nutritional targets in ventilated intensive care patients. Crit Care. 2009, 13: R187-10.1186/cc8181.PubMedCentralCrossRefPubMed
2.
go back to reference Davies AR, Froomes PR, French CJ, Bellomo R, Gutteridge GA, Nyulasi I, Walker R, Sewell RB: Randomized comparison of nasojejunal and nasogastric feeding in critically ill patients. Crit Care Med. 2002, 30: 586-590. 10.1097/00003246-200203000-00016.CrossRefPubMed Davies AR, Froomes PR, French CJ, Bellomo R, Gutteridge GA, Nyulasi I, Walker R, Sewell RB: Randomized comparison of nasojejunal and nasogastric feeding in critically ill patients. Crit Care Med. 2002, 30: 586-590. 10.1097/00003246-200203000-00016.CrossRefPubMed
3.
go back to reference Treasure T, MacRae D: Minimisation: the platinum standard for trials? Randomisation doesn't guarantee similarity of groups; minimisation does. BMJ. 1998, 317: 362-363.PubMedCentralCrossRefPubMed Treasure T, MacRae D: Minimisation: the platinum standard for trials? Randomisation doesn't guarantee similarity of groups; minimisation does. BMJ. 1998, 317: 362-363.PubMedCentralCrossRefPubMed
4.
go back to reference Drenth JP, Engels LG: Diabetic gastroparesis. A critical reappraisal of new treatment strategies. Drugs. 1992, 44: 537-553. 10.2165/00003495-199244040-00002.CrossRefPubMed Drenth JP, Engels LG: Diabetic gastroparesis. A critical reappraisal of new treatment strategies. Drugs. 1992, 44: 537-553. 10.2165/00003495-199244040-00002.CrossRefPubMed
5.
go back to reference Berger MM, Revelly JP, Cayeux MC, Chiolero RL: Enteral nutrition in critically ill patients with severe hemodynamic failure after cardiopulmonary bypass. Clin Nutr. 2005, 24: 124-132. 10.1016/j.clnu.2004.08.005.CrossRefPubMed Berger MM, Revelly JP, Cayeux MC, Chiolero RL: Enteral nutrition in critically ill patients with severe hemodynamic failure after cardiopulmonary bypass. Clin Nutr. 2005, 24: 124-132. 10.1016/j.clnu.2004.08.005.CrossRefPubMed
6.
go back to reference Sefton EJ, Boulton-Jones JR, Anderton D, Teahon K, Knights DT: Enteral feeding in patients with major burn injury: the use of nasojejunal feeding after the failure of nasogastric feeding. Burns. 2002, 28: 386-390. 10.1016/S0305-4179(02)00006-2.CrossRefPubMed Sefton EJ, Boulton-Jones JR, Anderton D, Teahon K, Knights DT: Enteral feeding in patients with major burn injury: the use of nasojejunal feeding after the failure of nasogastric feeding. Burns. 2002, 28: 386-390. 10.1016/S0305-4179(02)00006-2.CrossRefPubMed
7.
go back to reference Berger MM, Revelly JP, Wasserfallen JB, Schmid A, Bouvry S, Cayeux MC, Musset M, Maravic P, Chiolero RL: Impact of a computerized information system on quality of nutritional support in the ICU. Nutrition. 2006, 22: 221-229. 10.1016/j.nut.2005.04.017.CrossRefPubMed Berger MM, Revelly JP, Wasserfallen JB, Schmid A, Bouvry S, Cayeux MC, Musset M, Maravic P, Chiolero RL: Impact of a computerized information system on quality of nutritional support in the ICU. Nutrition. 2006, 22: 221-229. 10.1016/j.nut.2005.04.017.CrossRefPubMed
8.
go back to reference Desachy A, Clavel M, Vuagnat A, Normand S, Gissot V, Francois B: Initial efficacy and tolerability of early enteral nutrition with immediate or gradual introduction in intubated patients. Intensive Care Med. 2008, 34: 1054-1059. 10.1007/s00134-007-0983-6.CrossRefPubMed Desachy A, Clavel M, Vuagnat A, Normand S, Gissot V, Francois B: Initial efficacy and tolerability of early enteral nutrition with immediate or gradual introduction in intubated patients. Intensive Care Med. 2008, 34: 1054-1059. 10.1007/s00134-007-0983-6.CrossRefPubMed
9.
go back to reference Villet S, Chioléro RL, Bollmann MD, Revelly JP, Cayeux MC, Delarue J, Berger MM: Negative impact of hypocaloric feeding and energy balance on clinical outcome in ICU patients. Clin Nutr. 2005, 24: 502-509. 10.1016/j.clnu.2005.03.006.CrossRefPubMed Villet S, Chioléro RL, Bollmann MD, Revelly JP, Cayeux MC, Delarue J, Berger MM: Negative impact of hypocaloric feeding and energy balance on clinical outcome in ICU patients. Clin Nutr. 2005, 24: 502-509. 10.1016/j.clnu.2005.03.006.CrossRefPubMed
Metadata
Title
Feed the ICU patient 'gastric' first, and go post-pyloric only in case of failure
Authors
Mette M Berger
Ludivine Soguel
Publication date
01-02-2010
Publisher
BioMed Central
Published in
Critical Care / Issue 1/2010
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc8862

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