• Clin Nutr · Feb 2004

    Comparative Study

    Experience of post-pyloric feeding in seriously ill patients in clinical practice.

    • J R Boulton-Jones, J Lewis, J C Jobling, and K Teahon.
    • Department of Gastroenterology, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PD, UK. robandakathome@hotmail.com
    • Clin Nutr. 2004 Feb 1;23(1):35-41.

    BackgroundMaintaining nutrition is an integral part of patient care and when it is possible enteral nutrition is regarded as superior to parenteral nutrition. Post-pyloric feeding may enable enteral feeding to be maintained in patients who cannot tolerate nasogastric feeding. The success of post-pyloric feeding in routine clinical practice is uncertain.MethodsOne hundred and forty six consecutive patients who had 150 separate episodes of post-pyloric feeding were identified. Casenotes were reviewed to assess indication for post-pyloric feeding, prior use of alternative methods of feeding, success of achieving nutritional requirements and patient outcome.ResultsA post-pyloric tube was successfully placed in 138 (92%) and nutritional requirements were met by post-pyloric feeding alone in 124 (83%). Post-pyloric feeding was used for between 2 and 254 days (median 14 days). Conditions for which post-pyloric feeding was used to administer nutritional support included burn injury, pancreatitis, sepsis, post-operative gastric stasis, bone marrow transplantation and chemotherapy induced vomiting. Fifty (33%) patients had an attempt at nasogastric feeding and 33 (22%) were on total parenteral nutrition before post-pyloric feeding was commenced. There was one major complication of a jejunal ulcer bleed in the series. Minor complications included displacement of the nasojejunal tube and failure to absorb feed related to gastrointestinal dysfunction.ConclusionsPost-pyloric feeding can be successfully used to maintain enteral nutrition in patients who would otherwise require parenteral nutrition.

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