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[Dysphagia] Enteral feeding in acute stroke
I wasn't sure - when pts were given TF, were they randomly assigned NGT vs PEG? I find this interesting. Just wondering if this could have been the kind of situation where perhaps the pts who were given PEGs were initially in worse shape than the pts given NGTs? And perhaps that could have been why they had worse outcomes rather than the type of tube specifically?
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In the third trial, the rate of death and poor outcome was higher with percutaneous endoscopic gastrostomy than with nasogastric feeding.
patients were allocated percutaneous endoscopic gastrostomy (PEG) or nasogastric feeding.
In the PEG versus nasogastric tube trial, 321 patients were enrolled by 47 hospitals in 11 countries. PEG feeding was associated with an absolute increase in risk of death of 1?0% (-10?0 to 11?9, p=0?9) and an increased risk of death or poor outcome of 7?8% (0?0 to 15?5, p=0?05).
Interpretation Early tube feeding might reduce case fatality, but at the expense of increasing the proportion surviving with poor outcome. Our data do not support a policy of early initiation of PEG feeding in dysphagic stroke patients.
Dr I Campbell-Taylor
Clinical Neuroscientist
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