Identificador persistente para citar o vincular este elemento: http://hdl.handle.net/10553/45967
Título: Multicenter, prospective, randomized, single-blind study comparing the efficacy and gastrointestinal complications of early jejunal feeding with early gastric feeding in critically ill patients
Autores/as: Montejo, Juan C.
Grau, Teodoro
Acosta, Jose
Ruiz-Santana, Sergio 
Planas, Mercé
García-De-Lorenzo, Abelardo
Mesejo, Alfonso
Cervera, Manuel
Sánchez-Álvarez, Carmen
Núñez-Ruiz, Rafael
López-Martínez, Jorge
Clasificación UNESCO: 32 Ciencias médicas
3206 Ciencias de la nutrición
Palabras clave: Enteral nutrition
Critical illness
Pneumonia
Aspiration
Intensive care units, et al.
Fecha de publicación: 2002
Publicación seriada: Critical Care Medicine 
Resumen: Objective: To compare the incidence of enteral nutrition-related gastrointestinal complications, the efficacy of diet administration, and the incidence of nosocomial pneumonia in patients fed in the stomach or in the jejunum. Design: Prospective, randomized multicenter study. Setting: Intensive care units (ICUs) in 11 teaching hospitals. Patients: Critically ill patients who could receive early enteral nutrition more than 5 days. Interventions: Enteral nutrition was started in the first 36 hrs after admission. One group was fed with a nasogastric tube (GEN group) and the other in the jejunum through a dual-lumen nasogastrojejunal tube (JEN group). Measurements and main results: Gastrointestinal complications were previously defined. The efficacy of diet administration was calculated using the volume ratio (expressed as the ratio between administered and prescribed volumes). Nosocomial pneumonia was defined according the Centers for Disease Control and Prevention's definitions. One hundred ten patients were included (GEN: 51, JEN: 50). Both groups were comparable in age, gender, Acute Physiology and Chronic Health Evaluation II, and Multiple Organ Dysfunction Score. There were no differences in feeding duration, ICU length of stay, or mortality (43% vs. 38%). The JEN group had lesser gastrointestinal complications (57% vs. 24%, p <.001), mainly because of a lesser incidence of increased gastric residuals (49% vs. 2%, p <.001). Volume ratio was similar in both groups. A post hoc analysis showed that the JEN group had a higher volume ratio at day 7 than the GEN group (68% vs. 82%, p <.03) in patients from ICUs with previous experience in jejunal feeding. Both groups had a similar incidence of nosocomial pneumonia (40% vs. 32%). Conclusions: Gastrointestinal complications are less frequent in ICU patients fed in the jejunum. Nevertheless, it seems to be a necessary learning curve to achieve better results with a postpyloric access. Early enteral nutrition using a nasojejunal route seems not to be an efficacious measure to decrease nosocomial pneumonia in critically ill patients.
URI: http://hdl.handle.net/10553/45967
ISSN: 0090-3493
DOI: 10.1097/00003246-200204000-00013
Fuente: Critical Care Medicine [ISSN 0090-3493], v. 30, p. 796-800
Colección:Artículos
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