Preventing diarrhoea in enteral nutrition: the impact of the delivery set hang time. Issue 8 (4th May 2015)

• Record Type: Journal Article
• Authors: Arevalo‐Manso, J. J.; Martinez‐Sanchez, P.; Juarez‐Martin, B.; Fuentes, B.; Ruiz‐Ares, G.; Sanz‐Cuesta, B. E.; Parrilla‐Novo, P.; Diez‐Tejedor, E.
• Is Part Of: International journal of clinical practice. Volume 69:Issue 8(2015)
• Page Start: 900
• Page End: 908
• Publication Date: 2015-05-04
• Subjects: Clinical medicine -- Periodicals; Medicine -- Periodicals; 610.5
• DOI: 10.1111/ijcp.12645
• Languages: English
• ISSNs: 1368-5031

Abstract

<abstract abstract-type="main" id="ijcp12645-abs-0001"> <title>Summary</title> <sec id="ijcp12645-sec-0001" sec-type="section"> <title>Background</title> <p>To meet the current recommendations for enteral tube feeding (ETF), we updated our previous practice in 2011 and began to use a 24‐h delivery set hang time (DSHT). We evaluated the impact of this update on the risk of diarrhoea and in diarrhoea‐free survival.</p> </sec> <sec id="ijcp12645-sec-0002" sec-type="section"> <title>Methods</title> <p>Observational, retrospective study with historical controls on ischaemic and haemorrhagic stroke patients undergoing ETF. Diarrhoea occurrence (≥ 3 liquid stools in 24 h) was compared between patients with a 24 h DSHT (2011–2014) and a 72/96 h DSHT (2010–2011). The analysis was conducted using Kaplan–Meier curves and a Cox regression model.</p> </sec> <sec id="ijcp12645-sec-0003" sec-type="section"> <title>Results</title> <p>A total of 175 patients were included [median age 81 years (IQR = 12), 46.9% males], 103 in the group with a 24 h DSHT and 72 in the group with a 72/96 h DSHT. The group with a 24 h DSHT had a lower diarrhoea frequency (13.6% vs. 34.7%, risk ratio: 0.39, 95% CI: 0.22–0.70, p = 0.001) and a lower diarrhoea incidence rate (0.87 vs. 2.32 cases of diarrhoea/100 patient*day, rate ratio: 0.37, 95% CI: 0.19–0.72, p = 0.004). The Kaplan–Meier curves showed a longer diarrhoea‐free survival for this group (p = 0.003, log‐rank test). A 24 h DSHT was associated with a lower risk of diarrhoea (HR = 0.27, 95% CI: 0.12–0.61, p = 0.002), adjusted by albumin, stroke severity, intravenous thrombolysis, the administration of clindamycin and cefotaxime, and the administration of an enteral formula for diabetic patients.</p> </sec> <sec id="ijcp12645-sec-0004" sec-type="section"> <title>Conclusions</title> <p>The 24 h DSHT was independently associated with a lower risk of diarrhoea and longer diarrhoea‐free survival in hospitalised patients with acute stroke under ETF, compared with a 72/96 h DSHT.</p> </sec> </abstract>