期刊
JOURNAL OF CLINICAL AND EXPERIMENTAL HEPATOLOGY
卷 14, 期 1, 页码 -出版社
ELSEVIER - DIVISION REED ELSEVIER INDIA PVT LTD
DOI: 10.1016/j.jceh.2023.07.413
关键词
early feeding; nasogastric tube; nutrition; variceal bleed; cirrhosis; rebleeding; encephalopathy; varices; portal pressure and systemic fasting
Early nasogastric tube feeding after endotherapy for variceal bleeding in patients with cirrhosis appears to be safe and well tolerated without increased risk of rebleeding or encephalopathy.
Background and aims: Limited data exist on the safety of early nasogastric (NG) feeding in patients with cirrhosis after endotherapy for variceal bleeding (VB). We studied the impact of early NG tube feeding in these patients in this proof-of-concept open-label randomized controlled trial. Methods: Eligible patients with cirrhosis undergo-ing endotherapy for VB were randomized to receive either a liquid diet through a 14 Fr NG tube (commencing 1 h after endotherapy) (early feeding [EF] group) or sips of water and lemon water orally (standard-of-care [SOC] group) for total duration of 48 h. The primary outcome was 5-day rebleeding in both arms. Other outcomes included 5-day infection rate, hepatic encephalopathy during hospitalization, and 6-week mortality. Results: Eighty patients (Mean age: 41 +/- 11.5 years; males [82.5%]; alcohol etiology [55%]) were included. Baseline median Child-Pugh and MELD scores were similar (CTP: 8 [IQR: 8-9] vs 9 [8-9.25]; P = 0.47 and MELDNa: 13 [10.75- 16.25] vs 15 [12-18.25]; P = 0.16). The 5-day rebleeding rates in EF and SOC groups were 2.5% and 5%, respectively (P = 0.55), and non-inferiority or superiority of either could not be demonstrated. The incidence of infection (2.5% [EF] vs 2.5% [SOC]; P = 1.00) and development of HE (5% [EF] vs 2.5% [SOC]; P = 0.36) during hospitali-zation were comparable. The average daily calorie and protein intake in the EF group during the 48 h was 1318 +/- 240 Kcals and 43.4 +/- 9.2 g of proteins. No patient in the EF group had feed intolerance. Conclusion: Early initiation of NG tube-based feeding after endotherapy in VB appears safe and well tolerated without the addi-tional risk of rebleeding or encephalopathy. ( J CLIN EXP HEPATOL 2024;14:101260)
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据