Is looped nasogastric tube feeding more effective than conventional nasogastric tube feeding for dysphagia in acute stroke?

Jessica R Beavan¹ , Simon Conroy¹ , Jo Leonardi-Bee¹ , Tim Bowling² , Catherine Gaynor² , John Gladman¹ , Dawn Good³ , Peter Gorman⁴ , Rowan Harwood³ , Jan Riley² , Tracey Sach¹ and Wayne Sunman³

¹Nottingham University School of Community Health Sciences, B Floor, Medical School, Queen's Medical Centre, Nottingham, NG7 2UH, UK

²Queen's Medical Centre, Nottingham University Hospitals Trust, Derby Road, Nottingham, NG7 2UH, UK

³Nottingham City Hospital Campus, Nottingham University Hospitals Trust, Hucknall Road, Nottingham, NG5 1PB, UK

⁴Derbyshire Royal Infirmary, London Road, Derby, DE1 2QY, UK

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Trials 2007, 8:19doi:10.1186/1745-6215-8-19


Published:	3 August 2007

Abstract

Background

Dysphagia occurs in up to 50% of patients admitted to hospital with acute strokes with up to 27% remaining by seven days. Up to 8% continue to have swallowing problems six months after their stroke with 1.7% still requiring enteral feeding. Nasogastric tubes (NGT) are the most commonly used method for providing enteral nutrition in early stroke, however they are easily and frequently removed leading to inadequate nutrition, early PEG (Percutaneous Endoscopic Gastrostomy) insertion or abandoning of feeding attempts. Looped nasogastric tube feeding may improve the delivery of nutrition to such patients.

Methods

Three centre, two arm randomised controlled trial, with 50 participants in each arm comparing loop (the intervention) versus conventional nasogastric tube feeding. The primary outcome measure is proportion of intended feed delivered in the first 2 weeks. The study is designed to show a mean increase of feed delivery of 16% in the intervention group as compared with the control group, with 90% power at a 5% significance level. Secondary outcomes are treatment failures, mean volume of feed received, adverse events, cost-effectiveness, number of chest x-rays, number of nasogastric tubes and tolerability.

Trial Registration

ISRCTN Number: ISRCTN61174381