Frequency of aspiration pneumonia in persons with dysphagia : percutaneous endoscopic gastrostomy vs nasogastric tube

Abstract

Overview of topic: Aspiration pneumonia is highly common and is one of the highest causes of morbidity in patients using enteral nutrition. A comparison between two modes of enteral nutrition highlight which mode of feeding results in less episodes of aspiration pneumonia in patients with swallowing disturbances. The Research Question: In patients with dysphagia, is a percutaneous endoscopic gastrostomy more effective in reducing aspiration pneumonia than a nasogastric tube? PICO Elements: (P) Patients with dysphagia, (I) Use of Percutaneous Endoscopic Gastrostomy, ( C) Use of Nasogastric Tube, (O) Change in aspiration pneumonia cases. Method: Key terms of the PICO question were used in conducting the literature search though databases like Cochrane, Google Scholar and HyDi. Exclusion and inclusion criteria were listed a PRISMA 2009 checklist was used to exclude irrelevant articles. The chosen studies were critically appraised using CASP Tools. Inclusion and Exclusion Criteria: Including studies using two or more keywords in the title, published within the last 10 years, written and published in English and having full article available online. Excluding articles having less than two keywords in the title, studies which are eleven years or older, studies written and published in another language which is not English and excluding articles which are not fully available online. Results: Five studies were chosen for this dissertation including two systematic reviews, one meta-analysis, one retrospective study and one prospective case-controlled study. These studies showed differences in episodes of aspiration pneumonia as well as discussed other outcomes and variables encountered. Conclusion: The studies chosen concluded that risk and episodes of aspiration pneumonia was less in patients using a percutaneous endoscopic gastrostomy, compared to those using a nasogastric tube. However, more research on enteral nutrition should be conducted. Implications and recommendations: Highlighted is the importance of continuous education to staff members caring for patients with enteral nutrition, patients using modes of enteral nutrition and relatives caring for someone with enteral nutrition to decrease incidences of aspiration pneumonia and other outcomes as well as promoting better quality of life.