成人采间歇性鼻胃管灌食后,不关闭.pdfVIP

成人採間歇性鼻胃管灌食後，不關閉 鼻胃管路，接上引留袋並置放高於枕 頭，以降低吸入性肺炎? Journal Club 引言人:王錦雲 2016年10月11 日 Nasogastric Tube Feeding • Definition -- Nasogastric tube feeding is defined as the delivery of nutrients from the nasal route into the stomach via a feeding tube. (MOH NURSING CLINICAL PRACTICE GUIDELINES, 2010) • Nasogastric feeding is most appropriate when starting EN (McClave, S. A., 2016) • Nasal tubes are mainly used for short-term enteral feeding (4-6 wk) and in situations where other methods of enteral feeding are contraindicated. (Blumenstein, I., Shastri, Y. M., Stein, J., 2014) Indication Commissioned by the National Institute for Clinical Excellence ，2006 Tube-related complications of enteral tube feeding World J Gastroenterol 2014 July 14; 20(26): 8505-8524 吸入性肺炎定義 • 指異物或胃內容物，由口咽吸入氣管，進入下呼吸 道，導致肺部疾病；如果吸入肺部的物質是無菌的 胃酸，可能會造成急性肺損傷（acute lung injury ）；如果是含菌的腸胃道液或是夾帶口腔內大量細 菌，就可能造成細菌性肺炎 （Marik, 2011; Shimada et al., 2010 ）。 Background • Nasogastric tube feeding may be accompanied by complications. • Aspiration is one of the most feared complications of EN. (McClave, s. A, 2009) • Thus, it is important for the practitioner to be aware of how to prevent these complications so that nasogastric tube feeding can be administered successfully and safely. • Diagnosis of aspiration is difficult without the use of costly procedures; thus, the incidence of this condition is unclear. (American Association of Critical-Care Nurses ,2016 ) • 要實際預測肺吸入很困難，所以影像的檢查（胸部X