HOMEPRODUCTSCOMPANYCONTACTFAQResearchDictionaryPharmaSign Up FREE or Login

Elemental diets may reduce the risk of aspiration pneumonia in bedridden gastrostomy-fed patients.

AbstractOBJECTIVES:
Our clinical experience suggested that elemental diets were associated with a reduction in aspiration pneumonia among bedridden patients with percutaneous endoscopic gastrostomy (PEG). We compared the effects of elemental and standard liquid diets on the risk of clinical aspiration pneumonia and gastric emptying in bedridden patients receiving PEG feedings.
METHODS:
Study 1: consecutive bedridden PEG patients received elemental diets or standard liquid diets in the same fashion. The frequency of defecation, diet aspirated from the trachea, and aspiration pneumonia during hospitalization were prospectively recorded. Study 2: a randomized, crossover trial using elemental or standard liquid diets containing (13)C sodium acetate as a tracer given to bedridden PEG patients who had experienced aspiration pneumonia. (13)C breath tests were performed to estimate gastric emptying.
RESULTS:
Study 1: 127 patients were enrolled, 60 with elemental and 67 with standard liquid diets. The diet was aspirated from the trachea in none (0%) with the elemental diet vs. 8 (11.9%) with standard liquid diets (P=0.0057); aspiration pneumonia developed none with the elemental diet vs. 5 (7.5%) with standard liquid diets (P=0.031) (number needed to treat 14, 95% confidence interval 7-85). Study 2: 19 patients were enrolled. The elemental diet was associated with a significant increase in the 10, 30 or 50% emptying (excretion) time (P<0.001) and increased the area under the curve (% dose/h) compared with the standard liquid diet (P<0.05).
CONCLUSIONS:
Elemental diets were associated with more rapid gastric empting and fewer episodes of aspiration than standard liquid diets in bedridden PEG patients. They may be preferred for bedridden PEG patients especially who have experienced aspiration pneumonia. Properly performed randomized-controlled trials are needed to prove this potential benefit.
AuthorsAkira Horiuchi, Yoshiko Nakayama, Ryosei Sakai, Manabu Suzuki, Masashi Kajiyama, Naoki Tanaka
JournalThe American journal of gastroenterology (Am J Gastroenterol) Vol. 108 Issue 5 Pg. 804-10 (May 2013) ISSN: 1572-0241 [Electronic] United States
PMID23399554 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Carbon Radioisotopes
  • Sodium Acetate
Topics
  • Aged
  • Aged, 80 and over
  • Bed Rest
  • Breath Tests
  • Carbon Radioisotopes
  • Cross-Over Studies
  • Diet, Fat-Restricted
  • Enteral Nutrition (adverse effects, methods)
  • Female
  • Food, Formulated
  • Gastric Emptying
  • Gastrostomy (adverse effects, methods)
  • Humans
  • Incidence
  • Inpatients
  • Japan (epidemiology)
  • Male
  • Pneumonia, Aspiration (epidemiology, etiology, prevention & control)
  • Prospective Studies
  • Risk
  • Sodium Acetate
  • Treatment Outcome

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!


Choose Username:
Email:
Password:
Verify Password:
Enter Code Shown: