2018 Oct 1;108(4):830-841. doi: 10.1093/ajcn/nqy133. An analysis of the advantages of Stamm and percutaneous gastrostomy. Coben RM, Weintraub A, DiMarino AJ Jr, Cohen S. Gastroesophageal reflux during gastrostomy feeding. Raff MH, Cho S, Dale R. A technique for positioning nasoenteral feeding tubes. A comparison of continuous and intermittent enteral nutrition in NICU patients. Found insideEarly feeding, feeding tolerance, and lactase activity in preterm infants. J Pediatr. ... 20 Premji S, Chessell L. Continuous nasogastric milk feeding versus intermittent bolus milk feeding for premature infants less than 1500 grams. Found inside – Page 374Suggested approach Figure 24.4 shows a generalized schema that provides guidelines for minimal enteral feedings in VLBWI ... enteral feeding” regimens involve such small volumes that the bolus versus continuous feeding argument is moot. Nurs Res 1990; 39:148-152. Values are means ± SEM, n = 5–7. Early postoperative nutritional support using the serosal tunnel jejunostomy. Found inside – Page 656These include bolus Weinryb reported that patients with a previous history of feeding , intermittent feeding , or continuous feeding . Kocan pneumonia were at highest risk.79 Siddique et al , in a retro- and Hickisch reported no ... The major role for fiber in enteral formulas is likely the contribution of short-chain fatty acids, which are trophic for bowel mucosa. Tube Feeding Using the Bolus Method This information will help teach you how to use the bolus method to feed yourself and take your medications through your percutaneous endoscopic gastrostomy (PEG), gastrostomy tube (GT), or nasogastric tube (NGT). Strodel WE, Lemmer J, Eckhauser F, Botham M, Dent T. Early experience with endoscopic percutaneous gastrostomy. INITIATION • Bolus/Gravity Br J Surg 1979;66:727-732. Crit Care Med 1983;11:7-9. Pharmacotherapy 1990;10:356-361. The benefits of bolus vs continuous feeding in LBW infants have been debated for some time since both the modalities of feed-ing present advantages and disadvantages; theoretical risks and benefits of both continuous nasogastric milk feeding and intermit-tent bolus milk feeding have been proposed. Am J Clin Nutr. Lipman TO. Kirby DF, Clifton GL, Turner H, Marion DW, Barrett J, Gruemer H-DF. Intravenous erythromycin for postpyloric intubation. JPEN 1987;11:412-421. showed that the team approach reduced complications compared with the nonteam patients and resulted in better attainment of nutritional goals.190 In addition, a review of the role of nutrition support teams showed that enough favorable evidence exists for cost-effectiveness to support establishing nutrition support teams.191 Even while debate still continues concerning the validity of aggressive nutritional support in reducing morbidity, mortality, and hospital stay, the use of a nutrition support team allows a comprehensive and orderly approach to aggressive nutritional therapy in a very complex patient population. This book analyses current practices in HPN, with a view to inform best practice, covering epidemiology of HPN in regions including the UK and Europe, USA and Australia, its role in the treatment of clinical conditions including ... Saltzberg DM, Anand K, Juvan P, Joffe I. Colocutaneous fistula: an unusual complication of percutaneous endoscopic gastrostomy. Am J Gastroenterol 1984;79:113-116. Bucklin DL, Gilsdorf RB. Intolerance to enteral feeding in the brain-injured patient. The effects of an arginine-free enteral diet on wound healing and immune function in the postsurgical rat. JAMA 1991;265:1426-1428. Bolus feeding also led to an increase in concentrations of insulin (P = 0.0024) and peptide YY (P < 0.0001), not seen with continuous feeding. Course Objectives: • Identify the benefits of bolus feeding for patients with head & neck cancer. Surg Gynecol Obstet 1991;173:401. The influence of enteral feedings on sustained release theophylline absorption. Am J Infect Control 1992;20:202-205. Heart Lung 1990;19:362-370. Surg Gynecol Obstet 1979;148:367-370. . Ann Surg 1989;209:455-461. Does food affect acute inflammatory bowel disease? 9. Radiology 1986;158:543-545. Feeding via a syringe (bolus feeding) Only enteral syringes, which are generally purple, have the word 'Enteral' on them and have either a female luer or catheter tip end, can be used to administer feed, water or medications via an enteral . Enteral provision of caloric intake favorably modulates disease severity,[1,2] immune system function, gastrointestinal integrity, and mucosal host defenses. Heyman S. The radionuclide salivagram for detecting the pulmonary aspiration in an infant. 300-400mL every 3-6 hours, 30-60 min infusion using gravity drip or feeding pump infusion and feeding bag. Shike M, Schroy P, Ritchie MA, Lightdale CJ, Morse R. Percutaneous endoscopic jejunostomy in cancer patients with previous gastric resection. AJR 1983;141:793-794. vanSonnenberg E, Cubberley DA, Brown LK, Wittich GR, Lyon JW, Stauffer AE. Nutrition can be administered through the tube using a continuous, cyclic, intermittent, or bolus (syringe) feeding. Elevated transaminases associated with an elemental diet. Neurol Res 2002;24:613-20. JPEN 1987;11:33-37. 8. J Am Coll Nutr 1991;10:633-648. Continuous versus intermittent bolus milk feeding in preterm infants: a meta-analysis Juan Ye1, Hong Chen2 and Hong-Gang Zhang3 Abstract Objectives: To analyze the evidence comparing the benefits and risks of continuous versus intermittent milk feeding in low birth weight (LBW) infants. They exist as separate nutrient units: fat, carbohydrate, or protein. NOURISHING G-TUBES: FEEDINGS CONT. Gut 1983;24:78-84. BMJ 1992;304: 1406-1409. Use of a nutrition support team, a multidisciplinary team consisting of physicians, dietitians, nurses, and pharmacists with expertise in nutritional support, can be valuable in managing patients in a comprehensive, cost-effective manner. Feeding jejunostomy with endoscopic guidance. Moore EE, Jones TN. Adams DB. Borlase BC, Bell SJ, Lewis EJ, Swails W, Bistrian BR, Forse A, Blackburn GL. JPEN 1989;14: 513-516. The technique of percutaneous endoscopic gastrostomy: a safe and cost-effective alternative to operative gastrostomy. Zarling EJ, Parmar JR, Mobarhan S, Clapper M. Effect of enteral formula infusion rate, osmolality and chemical composition upon clinical tolerance and carbohydrate absorption in normal subjects. Am J Gastroenterol 1990;85:448-451. Methods. Edes TE, Walk BE, Austin JL. This review reports on recent findings that bolus is advantageous compared to continuous feeding in supporting optimal protein anabolism. Branched chain amino acids in the treatment of encephalopathy: an analysis of variants. Crit Care Med 1987;15:506-509. Bolus feeding. The formula is poured slowly into at least a 35 ml catheter tip syringe attached to your child's feeding tube or button. Grant JP. Fluoroscopically guided nasoenteric feeding tube placement: results of a 1-year study. Continuous feeding is defined as delivering enteral nutrition with constant speed for 24 h via nutritional pump [2, 3]. Boutry C, El-Kadi SW, Suryawan A, Wheatley SM, Orellana RA, Kimball SR, Nguyen HV, Davis TA. Am J Gastroenterol 1989;84:1509-1512. JPEN 1991;15:298-302. Ann Intern Med 1992;116:540-543. Am Surg 1990;56:733-736. J Hum Nutr 1981;35:123-127. Angelillo VA, Bedi S, Durfee D, Dahl J, Patterson AJ, O'Donohue WJ Jr. Feeding time is a social time. JPEN 1984;8:679-681. Ann Intern Med 1978;89:221-222. J Pediatr. Early enteral nutrition after brain injury by percutaneous endoscopic gastrojejunostomy (PEG/J). Reproduced with permission from (35). Long-term oral branched-chain amino acid treatment in chronic hepatic encephalopathy: a randomized double-blind casein-controlled trial. This information booklet will tell you how to provide tube feeds using a gravity drip and syringe. Continuous feeding - Continuous feedings use a pump to slowly drip small amounts of formula through the feeding tube over several hours. Tao HH, Gillies RR. <>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 595.32 841.92] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Feeding gastrostomy: complications and mortality. Comparison of percutaneous endoscopic gastrostomy with Stamm gastrostomy. Hepatology 1989;10:228-246. In continuous feeding, an hourly rate of EN is administered using a feeding pump over 24 h. In cyclic feeding, EN is administered via a feeding pump in less than a 24-h time period. Dig Dis Sci 1992;37:1153-1161. Kelly TWJ, Patrick MR, Hillman KM. The use of a branched-chain amino acid-fortified, low aromatic amino acid enteral formulation may be useful in patients with hepatic encephalopathy. Assure that the most appropriate route, system, and method of tube-feeding delivery are provided. Hammarqvist F, Wernerman J, Ali R, von der Decken A, Vinnars E. Addition of glutamine to parenteral nutrition after elective abdominal surgery spares free glutamine in muscle, counteracts the fall in muscle protein synthesis, and improves nitrogen balance. Kozarek RA, Ball T, Ryan J. Percutaneous endoscopic gastrostomy: when push comes to shove, a comparison of two insertion methods. Curr Opin Clin Nutr Metab Care. See this image and copyright information in PMC. The rate of the continuous drip administration can be controlled with a pump, and the initial rate should be slow to allow for adaption to a hyperosmolar formula and to monitor for tolerance. The multitude of available products and conflicting information regarding product efficacy can often make appropriate aggressive nutritional support complicated. Continuous pump feeding at slower rates as compared to bolus feeding may be less associated with aspiration pneumonia. Premji SS, Chessell L. Continuous nasogastric milk feeding versus intermittent bolus milk feeding for premature infants less than 1500 grams. Philadelphia: Saunders, 1984:275-291. Accessibility J Cardiovasc Surg 1951;21:490-491. ing continuous feeding. Enteral Feeding System: One Institution's Experience . This important guide includes: The latest developments and scientific evidence in the field New data on nutrition and health surveillance programmes Revised and updated evidence-based guidelines for dietetic practice An exploration of how ... Surg Forum 1986;37:56-58. Continuous feeding is generally better tolerated than bolus feeds, produces more weight gain and is associated with reduced incidence of aspiration. Nestle Nutr Inst Workshop Ser. Philadelphia: Lea & Febiger, 1988:133-135. Unable to load your collection due to an error, Unable to load your delegates due to an error. Talbot JM. Arrows indicate time of feeding (32). Bolus/Syringe Feeding. Daly JM, Lieberman MD, Goldfine J, Shou J, Weintraub F, Rosato E, Lavin P. Enteral nutrition with supplemental arginine, RNA, and omega-3 fatty acids in patients after operation: immunologic, metabolic and clinical outcome. Meta-analyses of randomized trials have been unable to discern the clinical benefits due to confounding factors and methodological limitations. Found inside – Page 128Davis, T.A.; Fiorotto, M.L.; Suryawan, A. Bolus vs. continuous feeding to optimize anabolism in neonates. Curr. Opin. Clin. Nutr. Metab. Care 2015, 18, 102–108. [CrossRef] 12. Wang, Y.; Zhu, W.; Luo, B.-R. Continuous feeding versus ... The difference in response is attributable to the pulsatile pattern of amino acid-induced and insulin-induced translation initiation induced only by bolus feedi … 1 0 obj Gupta TP, Ehrinpreis MN. J Trauma 1986;26:874-880. Data are derived from the study reported in reference 35. Gastroenterology 1992;103:1236-1240. Gastroenterology 1989;96:989-996. Percutaneous endoscopic gastrojejunostomy: a dual center safety and efficacy trial. The effect of dietary fiber in a liquid diet on bowel function of mentally retarded individuals. Yeung CK, Young GA, Hackett AF, Hill GL. Enteral. Starkey JF, Jefferson PA, Kirby DF. It has also been shown that bolus feeding stimulates cyclical hormone surges . 2 0 obj Ann Surg 1988;207:598-603. Myth #3: Jejunal Feeding Causes Diarrhea This particular myth has been applied to both jejunal and gastric feedings alike, when in reality, diarrhea is a common complaint among Careers. Generally, tube feeding consists of continuous feeding and intermittent bolus feeding. Your baby may also like a pacifier during the feeding. Am J Clin Nutr 1993;57:73-80. Mickschl DB, Davidson LS, Fluornoy DJ, Parker DE. Whether bolus or continuous feeding is more beneficial has been controversial, largely due to limitations inherent in clinical studies, such as the presence of confounding variables and the inability to use invasive approaches. Park RHR, Allison MC, Lang J, Spence E, Morris AJ, Danesh BJZ, Russell RI, Mills PR. Continuous drip is administered via gravity or a pump and is usually tolerated better than bolus feedings. Heymsfield S, Casper K, Grossman G. Bioenergetic and metabolic response to continuous vs intermittent nasoenteric feeding. Surg Gynecol Obstet 1981;152:659-660. Am Surg 1991;57:338-340. They may take the form of a liquid, shake, pudding, or solid food bar and may be taken with or between meals. Nutrition in Necrotizing Enterocolitis and Following Intestinal Resection. Percutaneous endoscopic gastrostomy: indications, success, complications, and mortality in 314 consecutive patients. Epub 2011 Oct 19. Soy-polysaccharide effect on diarrhea in tube-fed, head-injured patients. There are three types of feeding methods to administer formula and water into feeding tubes. Conclusion: Continuous nasogastric feeding does not increase small bowel water content, thus fluid flux within the small bowel is not a major contributor to the etiology of tube feeding-related diarrhea. But, if your child needs it, it is actually a lot easier than you may think. Gut 1988;29:1309-1315. 2. Abbreviations used in this paper: NET, nasoenteric tube; NGT, nasogastric tube; OG, operative gastrostomy; PEG, percutaneous endoscopic gastrostomy; PEG/J, percutaneous endoscopic gastrojejunostomy; PEJ, percutaneous endoscopic jejunostomy; RV, residual volume. Lack of glucose elevation after simulated tube feeding with a low-carbohydrate, high-fat enteral formulation in patients with type I diabetes. Compared with standard enteral formulations in type I diabetics, this formulation produces a significantly lower postprandial glycemic response.189 Concerns with fructose include its ability to cause an elevation in serum lipids compared with other carbohydrates and its incomplete gastrointestinal absorption leading to abdominal distention and cramping. Standard isotonic polymeric formulations can meet most patients' nutritional needs. Fleisher D, Sheth N, Kou J. Phenytoin interaction with enteral feeding administered with nasogastric tubes. Gastroenterology 1995;108:1282-1301. Percutaneous gastrostomy: use of intragastric balloon support. Intermittent bolus feeding has a greater stimulatory effect on protein synthesis in skeletal muscle than continuous feeding in neonatal pigs. Gazzaneo MC, Suryawan A, Orellana RA, Torrazza RM, El-Kadi SW, Wilson FA, Kimball SR, Srivastava N, Nguyen HV, Fiorotto ML, Davis TA. Enteral nutrition is mainly performed in two methods of continuous feeding over a period of 16-24 hours and bolus feeding for 4-6 times per day . We sought to compare bolus (B) versus continuous (C) gastric feeding in brain injured patients. The completion of the bolus feeding is at time zero. Feeding intolerance may be associated with increased complications and costs. Smith CE, Marien L, Brogdon C, Faust-Wilson P, Lohr G, Gerald KB, Pingleton S. Diarrhea associated with tube feeding in mechanically ventilated critically ill patients. Found insideThere was no difference in the incidence of NEC (all-stage NEC 18 % in early vs. 15 % in the late group; RR: 1.20, 95 % CI: 0.77-1.87; p = 0.42; incidence of NEC stages 2 and 3 was 8 % in both groups) [i]. Bolus vs. continuous feeding ... Duckworth PF Jr, Kirby DF, McHenry L, DeLegge MH, Foxx-Orenstein A. Percutaneous endoscopic gastrojejunostomy (PEG/J) made easy: a new over-the-wire technique. Only 33% of total calories are provided as glucose, whereas fructose, a sugar with a low glycemic response, provides approximately one quarter of the carbohydrate calories. Larson DE, Burton DD, Schroeder KW, DiMagno EP. This edition offers a new bonus CD-ROM containing review questions and answers and more, and a downloadable image collection of illustrations from the book. Mayo Clin Proc 1992;67:1042-1049. bolus and continuous enteral nutrition. S End 1991;1:251-253. TEN versus TPN following major abdominal trauma: reduced septic morbidity. Arch Surg 1973;106:49-52. leaves the ports of the feeding tube, it is mixed immediately with gastric or intestinal secretions and diluted--this inconsistency in practice is difficult to rationalize. McIntyre PB, Powell-Tuck J, Wood SR, Lennard-Jones JE, Lerebours E, Hecketsweiler P, Galmiche J-P, Colin R. Controlled trial of bowel rest in the treatment of severe acute colitis. 2009 Jan;12(1):78-85. doi: 10.1097/MCO.0b013e32831cef9f. Crit Care Med 1992;20:1388-1394. Di Lorenzo C, Lachman R, Hyman PE. aspiration. Effect of formula composition on hepatic and intestinal drug metabolism during enteral nutrition. Found inside – Page 90Continuous feeds versus bolus feeding Both continuous as well as bolus feeding have been used in paediatric critical care. The pros and cons of both are well studied in the neonatal and adult setting [143, 144], but in paediatrics ... Infants in the continuous feeding group had an average shorter time to full feeds, better feeding tolerance and improved weight gain. Continuous pump feeding at slower rates as compared to bolus feeding may be less associated with aspiration pneumonia. Ciocon JO, Galindo-Ciocon DJ, Tiessen C, Galindo D. Continuous compared with intermittent tube feeding in the elderly. Johnson DA, Hacker JF III, Benjamin SB, Ciarleglio CA, Chobanian SJ, Van Ness WM, Cattau EL Jr. Percutaneous endoscopic gastrostomy effects on gastroesophageal reflux and the lower esophageal sphincter. Surgery 1981;90:244-251. Fine needle catheter jejunostomy--an assessment of a new method of nutritional support after major gastrointestinal surgery. Medium-chain triglyceride-supplemented formulations have been proposed as alternatives to long-chain fatty acids in patients with fat malabsorption. J Am Coll Nutr 1992;11:11-16. Placement of a feeding button ("one-step button") as the initial procedure. Bolus Feeding. Water, electrolytes and acid-base balance. Thus, a custom enteral solution can be devised or individual components added to a commercial formula to obtain higher levels of a particular nutrient. Critical Windows for the Programming Effects of Early-Life Nutrition on Skeletal Muscle Mass. Prevention and treatment information (HHS). Enteral feeds can be administered by continuous, cycled, intermittent or bolus methods, or a combination of these. Preshaw RM. Complications after percutaneous endoscopic gastrostomy removal. Surg Gynecol Obstet 1992;174:527-529. JPEN 1986;10:588-590. McClave SA, Snider HL, Lowen CC, McLaughlin AJ, Greene LM, McCoombs RJ, Rodgers L, Wright RA, Roy TM, Schumer MP, Pfeifer MA. Recent findings indicate that bolus feeding enhances protein synthesis more than continuous feeding and promotes greater protein anabolism. More information is needed concerning their practicality and effectiveness. Gastroenterology 1988;95:1206-1220. Kalafarentzos F, Alivizatos V, Panagopoulos K, Androulakis J. Nasoduodenal intubation with the use of metoclopramide. Detailed Description: Eligible subjects are randomized into 2 groups by random numbers generated by a computer programme: intermittent bolus feeding versus continuous feeding via a delivery pump. As a dietetic intern and a new dietitian one of the many questions I had was : "How do I know when to give a patient a bolus vs. a continuous tube feed?" The. American Gastroenterological Association technical review on tube feeding for enteral nutrition. During the first two weeks of feeds, when the feeds were dictated by the study protocol, there were more children in the bolus group that required a change in their feeding (in terms of decreasing volume, changing interval, holding feeds, changing the feeding method) compared to continuous chimney feeds: 68.2% vs 45.5% (p = 0.033). • Continuous or Intermittent • Over 30-60 minutes in some pediatric patients • Delivered up to 24 hours a day • Appropriate for JT and GT/NGT who require slower rate. Adams S, Dellinger EP, Wertz MJ, Oreskovich MR, Simonowitz D, Johansen K. Enteral versus parenteral nutritional support following laparotomy for trauma: a randomized prospective trial. With an easy to use searchable CD-ROM and extensive chapters on AIDS, cancer, transplantation, and long term care, this book is the most important manual for enteral and parenteral nutrition in the 21st century." J Am Coll Nutr 1991;10:209-212. J Nutr. bolus feeding requires less technology than pump feeding and can be tailored to the patient's needs and circumstances; whether they rely solely on bolus feeding or are using bolus feeding in conjunction with other feeding methods. The heterogeneity in methodology and outcomes among the 5 studies did not allow for a meta-analysis. Values are means ± SEM, n = 5–7. Palliation of small bowel obstruction by percutaneous gastrostomy in patients with progressive ovarian carcinoma. Steiner M, Bourges HR, Freedman LS, Gray SJ. is on a continuous feeding regimen. |�,L�4�_ A�B���~^k�\#s��-^M�V,�����n���A��k&W����Q�;� �H7�Zk��ng���7�1n���t�O�zϾ���Z�lI����pq � Recent findings: Stellato TA, Gauderer MWL. In: Rombeau JL, Caldwell MD, eds. Effects of nutrient substrate on immune function. Schnall HA, Falkenstein DB, Raicht RF. Tube feeding can be given by the intermittent bolus method, whereby milk is given over a short time (15 to 30 minutes), or by the continuous feeding method, by which milk is given over several hours. Oie S, Kamiya A, Hironaga K, Koshiro A. Microbial contamination of enteral feeding solution and its prevention. The inclusion of medium-chain fatty acids reduces osmolality. Patients who were not able to ingest feed orally but had preserved Because fiber has a potential protective effect for multiple disease states, including diverticulosis, colon cancer, diabetes, and heart disease, it may have a role for patients in long-term care facilities or patients who will require enteral formulations for a prolonged period of time. Greenberg GR, Fleming CR, Jeejeebhoy KN, Rosenberg IH, Sales D, Tremaine WJ. Percutaneous endoscopic gastrostomy: do surgeons and gastroenterologists get the same results? This site needs JavaScript to work properly. Continuous Renal Replacement Therapy provides concise, evidence-based, to-the-point bedside guidance about this treatment modality, offering quick reference answers to clinicians' questions about treatments and situations encountered in ... Ann Surg 1992;215:503-511. Incidence of pulmonary aspiration in intubated patients receiving enteral nutrition through wide- and narrow-bore nasogastric feeding tubes. Serpa LF, Kimura M, Faintuch J, Ceconello I. Metabolism 1987;36:570-575. Impact of continuous vs bolus feeding on splanchnic perfusion in very low birth weight infants: a randomized trial. Payne KM, King TM, Eisenach JB. During continuous feeding, amino acid and insulin levels remain constant, blunting the synthesis of proteins . J Pediatr Surg 1991;26:936-941. For short-term feeding (<30 days), use a nasal feeding tube b. Intermittent Bolus Compared With Continuous Feeding Enhances Insulin and Amino Acid Signaling to Translation Initiation in Skeletal Muscle of Neonatal Pigs. Comparison of continuous vs intermittent nasogastric enteral feeding in trauma patients: perceptions and practice. Management of premature removal of the percutaneous gastrostomy. This is a comprehensive, state of the art resource for dietitians, nurses, physicians and pharmacists involved in paediatric care. Enteral Feeding: Bolus Tube Feeds, Continuous Milk Feed (CMF), Bottle Feeds Page 2 of 6 Neonatal Guideline Procedure Position yourself so the infant is facing towards you during the feed so you can act promptly in the event of vomiting or distress. JPEN 1987;11:86-87. Percutaneous peritoneoscopic jejunostomy. Gastrointest Endosc 1990;36:311-312. Calvey H, Davis M, Williams R. Controlled trial of nutritional supplementation with and without branched chain amino acid enrichment, in treatment of alcoholic hepatitis. Ann Intern Med 1986:95;647-668. Marvel M, Bertino J. Wasiljew BK, Ujiki GT, Beal JM. Radiology 1983;149:449-453. Am J Gastroenterol 1991;86:1604-1609. Zachary TM, Lipman TO, Finkelstein JD. S End 1991;1:189-192. Found inside – Page 114Premji S, Chessell L. Continuous nasogastric milk feeding versus intermittent bolus milk feeding for premature infants less than 1500 grams. Cochrane Database Syst Rev 2003; 1:CD001819. 63. Shulman RJ, Redel CA, Stathos TH.
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