PDF(Pubmed)
Abstract：
UNASSIGNED: Limited data exist on the safety of early nasogastric (NG) feeding in patients with cirrhosis after endotherapy for variceal bleeding (VB). We studied the impact of early NG tube feeding in these patients in this proof-of-concept open-label randomized controlled trial.
UNASSIGNED: Eligible patients with cirrhosis undergoing endotherapy for VB were randomized to receive either a liquid diet through a 14 Fr NG tube (commencing 1 h after endotherapy) (early feeding [EF] group) or sips of water and lemon water orally (standard-of-care [SOC] group) for total duration of 48 h. The primary outcome was 5-day rebleeding in both arms. Other outcomes included 5-day infection rate, hepatic encephalopathy during hospitalization, and 6-week mortality.
UNASSIGNED: Eighty patients (Mean age: 41 ± 11.5 years; males [82.5%]; alcohol etiology [55%]) were included. Baseline median Child-Pugh and MELD scores were similar (CTP: 8 [IQR: 8-9] vs 9 [8-9.25]; P = 0.47 and MELDNa: 13 [10.75-16.25] vs 15 [12-18.25]; P = 0.16). The 5-day rebleeding rates in EF and SOC groups were 2.5% and 5%, respectively (P = 0.55), and non-inferiority or superiority of either could not be demonstrated. The incidence of infection (2.5% [EF] vs 2.5% [SOC]; P = 1.00) and development of HE (5% [EF] vs 2.5% [SOC]; P = 0.36) during hospitalization were comparable. The average daily calorie and protein intake in the EF group during the 48 h was 1318 ± 240 Kcals and 43.4 ± 9.2 g of proteins. No patient in the EF group had feed intolerance.
UNASSIGNED: Early initiation of NG tube-based feeding after endotherapy in VB appears safe and well tolerated without the additional risk of rebleeding or encephalopathy.
UNASSIGNED: Eligible patients with cirrhosis undergoing endotherapy for VB were randomized to receive either a liquid diet through a 14 Fr NG tube (commencing 1 h after endotherapy) (early feeding [EF] group) or sips of water and lemon water orally (standard-of-care [SOC] group) for total duration of 48 h. The primary outcome was 5-day rebleeding in both arms. Other outcomes included 5-day infection rate, hepatic encephalopathy during hospitalization, and 6-week mortality.
UNASSIGNED: Eighty patients (Mean age: 41 ± 11.5 years; males [82.5%]; alcohol etiology [55%]) were included. Baseline median Child-Pugh and MELD scores were similar (CTP: 8 [IQR: 8-9] vs 9 [8-9.25]; P = 0.47 and MELDNa: 13 [10.75-16.25] vs 15 [12-18.25]; P = 0.16). The 5-day rebleeding rates in EF and SOC groups were 2.5% and 5%, respectively (P = 0.55), and non-inferiority or superiority of either could not be demonstrated. The incidence of infection (2.5% [EF] vs 2.5% [SOC]; P = 1.00) and development of HE (5% [EF] vs 2.5% [SOC]; P = 0.36) during hospitalization were comparable. The average daily calorie and protein intake in the EF group during the 48 h was 1318 ± 240 Kcals and 43.4 ± 9.2 g of proteins. No patient in the EF group had feed intolerance.
UNASSIGNED: Early initiation of NG tube-based feeding after endotherapy in VB appears safe and well tolerated without the additional risk of rebleeding or encephalopathy.
摘要：
■关于食管静脉曲张破裂出血（VB）内镜治疗后肝硬化患者早期鼻胃（NG）喂养的安全性的数据有限。在这个概念验证开放标签随机对照试验中，我们研究了早期NG管喂养对这些患者的影响。
■接受VB内治疗的肝硬化患者被随机分配接受14FrNG管的流质饮食（内治疗后1小时开始）（早期喂养[EF]组）或小口水和柠檬水（标准护理[SOC]组），总持续时间为48小时。主要结果是两组患者均有5天的再出血。其他结果包括5天感染率，住院期间肝性脑病，6周死亡率。
■80例患者（平均年龄：41±11.5岁；男性[82.5%]；酒精病因[55%]）。基线中位数Child-Pugh和MELD评分相似(CTP:8[IQR:8-9]vs9[8-9.25];P=0.47,MELDNa:13[10.75-16.25]vs15[12-18.25];P=0.16)。EF组和SOC组5天再出血率分别为2.5%和5%,分别为(P=0.55)，两者的非劣效性或优越性都无法证明。住院期间感染发生率（2.5％[EF]vs2.5％[SOC]；P=1.00）和HE发展（5％[EF]vs2.5％[SOC]；P=0.36）具有可比性。EF组在48小时内的平均每日卡路里和蛋白质摄入量为1318±240Kcals和43.4±9.2g蛋白质。EF组中没有患者有饲料不耐受。
■VB内治疗后早期开始NG管喂养似乎安全且耐受性良好，没有再出血或脑病的额外风险。
■接受VB内治疗的肝硬化患者被随机分配接受14FrNG管的流质饮食（内治疗后1小时开始）（早期喂养[EF]组）或小口水和柠檬水（标准护理[SOC]组），总持续时间为48小时。主要结果是两组患者均有5天的再出血。其他结果包括5天感染率，住院期间肝性脑病，6周死亡率。
■80例患者（平均年龄：41±11.5岁；男性[82.5%]；酒精病因[55%]）。基线中位数Child-Pugh和MELD评分相似(CTP:8[IQR:8-9]vs9[8-9.25];P=0.47,MELDNa:13[10.75-16.25]vs15[12-18.25];P=0.16)。EF组和SOC组5天再出血率分别为2.5%和5%,分别为(P=0.55)，两者的非劣效性或优越性都无法证明。住院期间感染发生率（2.5％[EF]vs2.5％[SOC]；P=1.00）和HE发展（5％[EF]vs2.5％[SOC]；P=0.36）具有可比性。EF组在48小时内的平均每日卡路里和蛋白质摄入量为1318±240Kcals和43.4±9.2g蛋白质。EF组中没有患者有饲料不耐受。
■VB内治疗后早期开始NG管喂养似乎安全且耐受性良好，没有再出血或脑病的额外风险。
