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Risk factors for aspiration.

Norma A Metheny1

  • 1School of Nursing, Saint Louis University, Missouri 63104-1099, USA. methenna@slu.edu

JPEN. Journal of Parenteral and Enteral Nutrition
|October 31, 2002
PubMed
Summary

Critically ill patients on tube feeding face aspiration risks. Decreased consciousness and supine position are major factors, while evidence for other interventions remains limited.

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Area of Science:

  • Critical Care Medicine
  • Gastroenterology
  • Pulmonary Medicine

Background:

  • Aspiration is a significant risk in critically ill patients receiving tube feeding.
  • Existing research presents conflicting data on the precise contribution of various risk factors.
  • Clarifying these factors is crucial for effective patient management and prevention strategies.

Purpose of the Study:

  • To review and synthesize findings on risk factors associated with aspiration in tube-fed critically ill patients.
  • To address the existing confusion regarding the impact of specific risk factors on aspiration events.

Main Methods:

  • A literature search was performed to identify studies on aspiration risk factors in this patient population.
  • Key factors identified included level of consciousness, patient positioning, use of nasogastric tubes, mechanical ventilation, feeding methods, underlying conditions, and age.

Main Results:

  • Studies often have small sample sizes and varied definitions of aspiration, complicating direct comparisons.
  • A decreased level of consciousness and sustained supine position are consistently identified as primary risk factors.
  • Evidence regarding the impact of nasogastric tube characteristics and feeding delivery methods on aspiration risk is less conclusive.

Conclusions:

  • Decreased level of consciousness and sustained supine position are confirmed as significant aspiration risk factors.
  • Current evidence does not strongly support the routine use of small-bore feeding tubes to prevent aspiration.
  • Continuous feeding methods appear more supported than bolus/intermittent methods for high-risk patients, though further data is needed.

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