Complications of patients with severe traumatic brain injury on different enteral nutrition tube feeding methods: a Meta analysis

Abstract

Objective \nTo investigate the complications of severe craniocerebral injury patients with nasogastric and nasointestinal enteral nutrition, and to evaluate the complications systematically with Meta analysis method, so as to provide reference for clinical selection of suitable enteral feeding methods. \n \n \nMethods \nAll randomized controlled trials both domestic and abroad on enteral nutrition in patients with severe craniocerebral injury were collected by searching Wanfang database, CNKI, VIP database, PubMed, CINAHL Complete and Cochrane Library from the establish date to 1st October, 2018. ReVman 5.3 was used for meta-analysis after quality assessment of the documents that met the inclusion and exclusion criteria. \n \n \nResults \nFinally, 15 articles and 1 323 subjects were included. The results of Meta-analysis on the comparison incidence of complications in the severe craniocerebral injury patients with nasogastric and nasointestinal enteral nutrition showed that the incidence of vomiting reflux was [OR=0.21, 95%CI (0.14, 0.33) , P<0.000 01], the incidence of aspiration was [OR=0.35, 95%CI (0.20, 0.63) , P=0.000 4], the incidence of diarrhea was [OR=0.84, 95%CI (0.54, 1.29) , P=0.42], the incidence of upper gastrointestinal bleeding was [OR=0.53, 95%CI (0.33, 0.85) , P=0.008], the incidence of gastric retention was [OR=0.43, 95%CI (0.21, 0.88) , P=0.02], and the incidence of pulmonary infection was [OR=0.38, 95%CI (0.29, 0.51) , P<0.000 01]. \n \n \nConclusions \nNasointestinal enteral nutrition can reduce the incidence of gastric retention, upper gastrointestinal bleeding and pulmonary infection in patients with severe craniocerebral injury, but there is no statistical difference in diarrhea. There is no definite conclusion on vomiting reflux and aspiration, which needs further verification. \n \n \nKey words: \nMeta analysis;\xa0Severe craniocerebral injury;\xa0Enteral nutrition;\xa0Complications;\xa0Nasogastric tube;\xa0Nasointestinal tube