Home Enteral Tube Feeding in Children and Young People: A Review of Current Literature on Optimum Frequency and Mode of Dietetic Assessment and Monitoring in the Community Setting

IF 2.9 3区医学 Q3 NUTRITION & DIETETICS

Journal of Human Nutrition and Dietetics Pub Date : 2025-03-30 DOI:10.1111/jhn.70044

Hannah Baker, Sarah Durnan, Pearl Pugh

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引用次数: 0

Abstract

Introduction

Home enteral nutrition (HEN) is the provision of nutrition support administered via feeding tube designed to support growth and development when oral feeding is not possible. Post-hospital discharge, patients are provided with all necessary enteral feed and equipment for continued nutrition support in the community. Specialist HEN dietitians, typically undertake assessment and monitoring of growth, tolerance and correct administration of HEN within the community. However, national clinical guidelines specific to the assessment and monitoring of children in receipt of HEN do not exist.

Aim

This review sought to identify current evidence on (1) optimum frequency of HEN dietetic reviews and (2) ideal mode of review, including explicit criteria on how this might alter based on the child's age, nutritional parameters and clinical condition.

Methods

Two electronic databases, CINAHL and Medline were screened to identify relevant articles published between February 2006 and June 2022 that met the inclusion criteria, using a PEO (population, exposure, outcome) search strategy. The search yielded 1677 articles, these were screened by title, abstract and full text for suitability for inclusion within the final review. A total of 1674 articles were excluded, yielding three articles considered suitable for this review.

Results

Recommendations on frequency and mode of assessment and monitoring of this patient group varied between the three articles. There was a lack of consensus on ‘ideal’ dietetic care, and explicit guidance on how this may alter based on clinical presentation was not provided.

Conclusions

There is a paucity of evidence on the most effective and efficient assessment and monitoring of children in receipt of HEN. Evidence-based and person-centred clinical guidelines are needed to inform commissioners and healthcare professionals on the optimum monitoring of this patient group. Future research should explore children, family and clinician expectations and needs, with pertinence to patient age and primary diagnosis, type and adequacy of feed used, feed tolerance, tube-related complications and treatment, hydration status, biochemical monitoring, the use of telehealth platforms, obtaining anthropometric measurements and the effects of drug/nutrient interactions.

查看原文本刊更多论文

儿童和青少年的家庭肠内管喂养：目前关于社区环境中营养评估和监测的最佳频率和模式的文献综述

家庭肠内营养（HEN）是通过喂食管提供的营养支持，旨在在无法口服喂养的情况下支持生长发育。出院后，向患者提供所有必要的肠内饲料和设备，以便在社区继续提供营养支持。专业的HEN营养师通常负责评估和监测社区内HEN的生长，耐受性和正确管理。然而，目前还没有专门针对接受HEN的儿童进行评估和监测的国家临床指南。目的：本综述旨在确定(1)HEN饮食评价的最佳频率和(2)理想的评价模式的现有证据，包括如何根据儿童的年龄、营养参数和临床状况改变评价模式的明确标准。方法采用PEO （population, exposure, outcome）检索策略，筛选2006年2月至2022年6月期间发表的符合纳入标准的相关文章。检索得到1677篇文章，这些文章按照标题、摘要和全文进行筛选，以确定是否适合纳入最终综述。总共有1674篇文章被排除，只有3篇文章被认为适合本综述。结果三篇文章对该患者组的评估和监测频率和模式的建议有所不同。对于“理想”的饮食护理缺乏共识，也没有提供关于如何根据临床表现改变饮食护理的明确指导。结论对接受HEN的儿童进行最有效和最有效的评估和监测的证据不足。需要循证和以人为本的临床指南，以便告知专员和保健专业人员如何对这一患者群体进行最佳监测。未来的研究应探讨儿童、家庭和临床医生的期望和需求，并针对患者的年龄和初步诊断、使用的饲料类型和充足性、饲料耐受性、管道相关并发症和治疗、水合状态、生化监测、远程医疗平台的使用、获得人体测量数据以及药物/营养相互作用的影响。

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

Journal of Human Nutrition and Dietetics 医学-营养学

CiteScore

5.30

自引率

15.20%

发文量

133

审稿时长

6-12 weeks

期刊介绍： Journal of Human Nutrition and Dietetics is an international peer-reviewed journal publishing papers in applied nutrition and dietetics. Papers are therefore welcomed on: - Clinical nutrition and the practice of therapeutic dietetics - Clinical and professional guidelines - Public health nutrition and nutritional epidemiology - Dietary surveys and dietary assessment methodology - Health promotion and intervention studies and their effectiveness - Obesity, weight control and body composition - Research on psychological determinants of healthy and unhealthy eating behaviour. Focus can for example be on attitudes, brain correlates of food reward processing, social influences, impulsivity, cognitive control, cognitive processes, dieting, psychological treatments. - Appetite, Food intake and nutritional status - Nutrigenomics and molecular nutrition - The journal does not publish animal research The journal is published in an online-only format. No printed issue of this title will be produced but authors will still be able to order offprints of their own articles.