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Enteral Feeding Within Three Hours After Percutaneous Endoscopic Gastrostomy Placement: A Meta-analysis.
MedLine Citation:
PMID:  20733512     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: Traditionally, tube feedings have been delayed after gastrostomy placement to the next day and up to 24 hours postprocedure. However, results from various randomized clinical trials (RCTs) indicate earlier feeding may be an option. Therefore, we conducted a meta-analysis to analyze the effect of earlier feedings (≤3 h) after percutaneous endoscopic gastrostomy (PEG) placement.
METHODS: Various medical databases and recent abstracts from major conference proceedings were searched (8/09). Only RCTs on adult subjects that compared early (≤3 h) versus delayed or next-day feedings after PEG placement were included. Meta-analysis was performed using pooled estimates of complications, death ≤72 hours, and significant increases in the number of postprocedural gastric residual volume during day 1 using odds ratio (OR) with the fixed and random effects models. Heterogeneity was assessed by calculating the I2 measure of inconsistency. RevMan 5.0 was utilized for statistical analysis.
RESULTS: Five studies (N=355) met the inclusion criteria. No significant differences were noted between early (≤3 h) and delayed or next day feedings for patient complications [OR 0.78; 95% confidence interval (CI), 0.39-1.53; P=0.47], death in ≤72 hours (OR 0.60; 95% CI, 0.18-1.99; P=0.40), and number of significant gastric residual volume during day 1 (OR 1.46; 95% CI, 0.75-2.84; P=0.27). No publication bias and no significant heterogeneity were noted.
CONCLUSIONS: Early tube feeding ≤3 hours after PEG placement has no significant differences to delayed or next-day feeding in respect to complications, death in ≤72 hours, or number of significant gastric residual volumes at day 1.
Authors:
Nicholas M Szary; Murtaza Arif; Michelle L Matteson; Abhishek Choudhary; Srinivas R Puli; Matthew L Bechtold
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of clinical gastroenterology     Volume:  45     ISSN:  1539-2031     ISO Abbreviation:  J. Clin. Gastroenterol.     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-03-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7910017     Medline TA:  J Clin Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e34-8     Citation Subset:  IM    
Affiliation:
Division of Gastroenterology, University of Missouri School of Medicine, Columbia, MO.
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