| ObjectiveTo systematically review the effects of intermittent versus continuous nasogastric feeding in adult patients,with an expectation to provide a reference for clinical nurses to choose appropriate feeding method,and thus prevent or reduce the incidence of symptoms of gastrointestinal intolerance,such as gastric retention,diarrhea,constipation,etc.MethodsIn order to collect randomized controlled trials(RCTs)on this subject,We electronically searched CBMdisc,CNKI,WanFang Data,VIP,PubMed,CENTRAL,Web of Science,ScienceDirect,CINAHL,PQDT.In addition,we manually searched related journals and ongoing clinical trials(Chinese Clinical Trial Registry,ClinicalTrials.gov and ICTRP Search Portal).Data were searched from inception to December 2017.We also tracked references of relevant papers.Two reviewers independently screened literature,extracted data and assessed methodological quality of all included studies.RevMan5.3 software was then used to perform Meta-analysis.ResultsTotally 18 RCTs(13 Chinese literatures and 5 English literatures)involving 1561 participants were finally included.The Meta-analysis well suggested that intermittent feeding(IF)can not only reduced gastric residual volume(WMD=-30.91,95%CI[-33.38,-28.43],P<0.00001)and pH value of gastric juice(WMD=-0.48,95%CI[-0.49,-0.47],P<0.00001),but also was associated with lower incidences of gastric retention(RR=0.27,95%CI[0.15,0.49],P<0.0001),nausea and vomiting(RR=0.49,95%CI[0.26,0.93],P=0.03),constipation(RR =0.68,95%CI[0.47,0.99],P=0.04),aspiration(RR=0.24,95%CI[0.12,0.51],P=0.0002),aspiration pneumonia(RR=0.23,95%CI[0.12,0.41],P < 0.00001)and tube obstruction(RR=0.21,95%CI [0.08,0.56],P=0.002).There was no statistically significant difference not only in the incidences of diarrhea(RR=0.90,95%CI[0.71,1.16],P=0.42),abdominal distension(RR=0.61,95%CI[0.36,1.0 4],P=0.07)and gastrointestinal bleeding(RR=1.01,95%CI [0.41,2.49],P=0.99),but also in the levels of albumin(SMD=-0.30,95%CI[-0.68,0.09],P=0.13),prealbumin(WMD=-0.00,95%CI[-0.06,0.05],P=0.88),total protein(WMD=1.16,95%CI[-0.00,2.32],P=0.05).Conclusion1 IF is better than CF in decreasing gastric residual volume and the events of gastrointestinal intolerance,such as gastric retention,nausea and vomiting,constipation.2 IF is superior to CF in terms of fewer pH value of gastric juice and incidence of aspiration,aspiration pneumonia and tube obstruction.3 Whether use IF or CF,there was no difference not only in the incidence of diarrhea,abdominal distension and gastrointestinal bleeding,but also in the levels of albumin,prealbumin and total protein. |
