Abstract WP325: The Appropriate Body Position During Nasal-gastric Tube Feeding To Prevent The Aspiration Pneumonia In Acute Stroke Patients
Purpose: In acute stroke patients when initiating Nasal-gastric tube feeding (NGF) have a high risk for aspiration pneumonia, which may be related to the body position. We investigated the relationship between body position during NGF and aspiration pneumonia.
Method: We enrolled consecutive acute stroke patients, 1) who were admitted from June 2011 to May 2012, 2) with a diagnosis of acute stroke within five days, and 3) who initiated NGF within two days from admission due to altered mental state or severe dysphagia. We allocated these enrolled patients into two Group alternately according to the body position during NGF; patients in the complete lateral position (Group L [n=27]) with keeping nonparalyzed side below and head up at 30-60 degrees during NGF, and patients in the spine position (Group S [n=26]) with head up at 30-60 degrees. We evaluated patients’ baseline characteristics including neurological status and vital signs, inflammatory response parameters, and the number of patients with aspiration pneumonia. Aspiration pneumonia fit three criteria: 1) at least one event of aspiration during NGF, 2) infiltrative shadows on the plain chest radiograph, and 3) no evidence of community acquired pneumonia.
Results: We finally evaluated 47 patients (median age was 85 years old, 43% female). There were 32 patients with cerebral infarction and 15 with intracranial hemorrhage, median NIHSS score on admission was 17.5, and on the seventh day was 18 respectively. We analyzed 24 patients in Group L, and 23 in Group S. There was no difference in patients’ baseline characteristics, and inflammatory reaction parameters between the groups statistically significantly. However, the number of patients with aspiration pneumonia after admission was lower in Group L compared to Group S statistically significantly ( nine cases in Group L, 9 cases in Group S, P=0.034).
Conclusion: The complete lateral position during the NGF has the potential to prevent aspiration pneumonia for acute stroke patients
- © 2012 by American Heart Association, Inc.