Evaluation of early feeding through nasogastric tube in patients after cardiovascular surgery at the Hanoi Heart Hospital

Objectives: The goal of the study was to describle and understand the factors related to the nasogastric tube feeding in patients after cardio-vascular surgery. Methods: The study involved 100 consecutive patients who underwent cardio-vascular surgery at Hanoi Heart Hospital from April 1 to August 3, 2019..All subjects underwent assessed with the early feeding through nasogastric tube after 6 hours operation. Main results: The mean age of the patients was 54.4 ± 14.5 years old. The percentage of men were 48%, BMI <18.5 were 25%, used inotropic drug were 46% and sedative were 27%. The incidence of patients with abdominal distension and vomiting were 13%. No complications related to early feeding. Factors related to the residual index were sedation and duration of mechanical ventilation. Conclusion: Early nasogastric tube feeding in patients after cardiac and vascular surgery is safe, feasible and feasible.

Case Report: Acute Submandibular Glanditis Caused by Nasogastric Tube Feeding in A Subject with Poorly Controlled Diabetes Mellitus

Background Enteral tube feeding is an effective method of providing nutrients for patients who are unable to meet their nutritional requirements and patients with parenteral nutrition are possible the increased risk of infection. The submandibular gland is one of the salivary glands and some of sialadenitis are caused by obstruction of the salivary outflow tract. Case presentation A 91-year-old woman had parenteral nutrition with nasogastric tube feeding. Her background history was repeated angina and myocardial infarction and performed percutaneous coronary intervention and coronary artery bypass grafting, type 2 diabetes (T2DM), heart failure, atrial fibrillation and sick sinus syndrome and performed, pacemaker placement. She was continued parenteral nutrition with nasogastric tube feeding for 20 days, and suddenly she had high fever and elevated infection markers under poorly glycemic control. We diagnosed her as acute submandibular glanditis. We treated her with antibiotics therapy, extubation, daily massage of the submandibular gland and strict glycemic control, and her neck swelling disappeared about 11 days after such treatment. Conclusions We reported acute submandibular glanditis induced by nasogastric tube feeding under poorly controlled diabetes mellitus. We have to pay attention to glycemic control in subjects under parenteral nutrition with tube feeding management.

Association between teeth loss and nasogastric tube feeding dependency in older adults from Taiwan: a retrospective cohort study

Background To examine the association between teeth loss and nasogastric tube feeding dependency in older people. Methods The National Health Interview Survey (NHIS) 2005, 2009, and 2013 in Taiwan. Participants were selected by a multistage stratified sampling method and baseline characteristics, including socioeconomic status and health habits, were obtained by well-trained interviewers. The NHIS was linked with the National Health Insurance research database 2000–2016 and the National Deaths Dataset, which contains all the medical information of ambulatory and inpatient care. Cox regression was used to examine the association between the number of teeth lost and nasogastric tube feeding dependency. Results There were 6165 adults older than 65 years old enrolled in the analysis, with 2959 male (48%) and the mean (SD) age was 73.95(6.46) years old. The mean follow-up duration was 6.5(3.3) years. Regarding the teeth loss categories, 1660 (26.93%), 2123 (34.44%), and 2382 (38.64%) of participants were categorized as having no teeth loss, loss of 1–9 teeth, and loss of 10–28 teeth, respectively. During 39,962 person-years of follow-up, new-onset nasogastric feeding dependency was recognized in 220(13.25%), 256(12.06%), and 461(19.35%) participants who were categorized as having no teeth loss, loss of 1–9 teeth, and loss of 10–28 teeth, respectively. Kaplan-Meier curves demonstrated significant findings (Log-rank P < 0.01). After potential confounders were adjusted, compared with those without teeth loss, older adults who had lost 10–28 teeth had significantly increased risks of occurrence nasogastric feeding dependency (AHR, 1.31; 95% CI, 1.05–1.62; p-value = 0.02). Furthermore, a significant dose-response relation between the number of teeth lost and increased risk of nasogastric feeding was found (p for trend< 0.01). Conclusions Older adults who had lost 10–28 teeth had a significantly increased risk of nasogastric tube feeding dependency. Early identification of the oral disease is crucial for the prevention of the occurrence of teeth loss and the following nutrition problems, which would reduce risk of nasogastric tube feeding dependency.

COVID-19 pandemic exacerbates eating disorder by social and intrafamilial isolations: importance of familial relationships (Preprint)

UNSTRUCTURED Background: Coronavirus disease-2019 (COVID-19) pandemic makes children and their parents psychologically stressed. We present a patient with an eating disorder (ED) that rapidly worsened due to stresses and isolations and that was improved by family meeting to reconstitute their relationships, during the pandemic. Case presentation: A father found that his 9-year daughter rapidly lost her weight because of poor oral intake. Her weight had already stopped gaining before the pandemic and rapidly decreased to 22 kg during the pandemic. We diagnosed her as having an ED and administrated nasogastric tube feeding. We guessed that not only social isolations but a disruption of relationship between her and her parents, both of which occurred by the pandemic, also caused her ED. In a family meeting, she revealed that she felt anxious more during the pandemic. After the meeting, her parents rescheduled their works and have dinners together every night. She could eat sufficiently and weigh 31.8 kg. Conclusions: ED children, whose symptoms worsened during the pandemic, are increased during the pandemic since they feel loneliness by social and intrafamilial isolations. Furthermore, the parents are also stressed during the pandemic. Children including those with ED experienced stress directly from the advent of the COVID-19 pandemic and indirectly from their parents. Pediatricians should be concerned that children might experience great stress during and after the pandemic.

Impact of nasogastric tube feeding on swallowing function in patients with dysphagia: a pilot study

During dysphagia treatment, direct oral swallowing therapy is applied to some patients temporarily fed via nasogastric tube. However, the risk of aspiration in oral swallowing while nasogastric tube in situ may be disregarded in a standard videofluoroscopic swallowing study performed without a nasogastric tube. To evaluate the diagnostic significance of nasogastric tube in situ videofluoroscopic swallowing study of nectar and pureed diet compared to the standard videofluoroscopic swallowing study without nasogastric tube. Videofluoroscopic swallowing study records of dysphagia patients conducted between June and August 2017 in a university hospital were collected for review. Rosenbek’s penetration-aspiration scale, diagnostic criteria of aspiration were used to define aspiration. videofluoroscopic dysphagia scale for videofluoroscopic swallowing study with or without nasogastric tube were compared for nectar and pureed diet swallowing. Patients had various duration of nasogastric tube feeding. Paired T-test comparing the videofluoroscopic dysphagia scales for videofluoroscopic swallowing study with or without nasogastric tube revealed significant aggravation of swallowing dysfunction in nectar drinking while nasogastric tube in situ. This aggravation was noted in 19% (n=4) of patients who suffered from stroke regardless of nasogastric tube duration. Nasogastric tube in situ videofluoroscopic swallowing study, at least of nectar drinking could be beneficial in selecting a safe candidate for direct oral swallowing therapy in conjunction with the conventional nasogastric tube removed videofluoroscopic swallowing study.