When to feed after percutaneous endoscopic gastrostomy: A systematic review and meta-analysis of randomized controlled trials.

IF 2.1 4区医学 Q3 NUTRITION & DIETETICS

Nutrition in Clinical Practice Pub Date : 2024-10-01 Epub Date: 2024-07-07 DOI:10.1002/ncp.11184

Matthew L Bechtold, Zahid Ijaz Tarar, Muhammad N Yousaf, Ghady Moafa, Abdul M Majzoub, Xheni Deda, Michelle L Matteson-Kome, Srinivas R Puli

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引用次数: 0

Abstract

Background: Initiation of feeding after percutaneous endoscopic gastrostomy (PEG) placement has been debated. Randomized controlled trials (RCTs) have been performed on early feeding compared with delayed feeding after PEG placement with varying results. Therefore, a meta-analysis was conducted examining early vs delayed feeding after placement of a PEG.

Methods: A comprehensive search of databases was conducted in January 2024. Peer-reviewed published RCTs comparing early feeding (≤4 h) with delayed feeding (>4 h) were identified and included in the meta-analysis. Meta-analysis was completed using pooled estimates of overall complications, individual complications, mortality ≤72 h, and number of day 1 significant gastric residual volumes.

Results: Six RCTs (n = 467) were included in the analysis. Comparison of early feeding with delayed feeding after PEG showed no statistically significant differences for overall complications (P = 0.18), mortality ≤72 h (P = 0.3), and number of day 1 significant gastric residual volumes (P = 0.05). No differences were also noted for individual complications, including vomiting, wound infection, bleeding, or diarrhea.

Conclusion: Feeding ≤4 h after PEG have no differences in minor and major complications compared with that of delayed feeding. Early feeding ≤4 h is safe and should be recommended in future guidelines.

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经皮内镜胃造口术后何时进食？随机对照试验的系统回顾和荟萃分析。

背景：经皮内镜胃造口术（PEG）置管后开始喂食一直备受争议。已进行的随机对照试验（RCT）对置入 PEG 后早期喂养与延迟喂养进行了比较，结果各不相同。因此，我们对放置 PEG 后早期喂养与延迟喂养进行了荟萃分析：方法：2024 年 1 月对数据库进行了全面检索。方法： 2024 年 1 月对数据库进行了全面搜索，确定了经同行评审的已发表 RCT，这些 RCT 对早期喂养（≤4 小时）和延迟喂养（>4 小时）进行了比较，并纳入了荟萃分析。使用总体并发症、单个并发症、≤72 小时死亡率和第 1 天显著胃残留量的汇总估计值完成了荟萃分析：分析纳入了六项研究性临床试验（n = 467）。PEG术后早期喂养与延迟喂养的比较结果显示，在总体并发症（P = 0.18）、72小时以内死亡率（P = 0.3）和第1天显著胃残留量数量（P = 0.05）方面没有统计学差异。呕吐、伤口感染、出血或腹泻等个别并发症也无差异：结论：PEG术后≤4小时喂食与延迟喂食相比，在轻微和主要并发症方面没有差异。早期喂食≤4 小时是安全的，应在今后的指南中予以推荐。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Nutrition in Clinical Practice 医学-营养学

CiteScore

6.00

自引率

9.70%

发文量

128

审稿时长

3 months

期刊介绍： NCP is a peer-reviewed, interdisciplinary publication that publishes articles about the scientific basis and clinical application of nutrition and nutrition support. NCP contains comprehensive reviews, clinical research, case observations, and other types of papers written by experts in the field of nutrition and health care practitioners involved in the delivery of specialized nutrition support. This journal is a member of the Committee on Publication Ethics (COPE).