Effects of Enteral Feeding Pump and Intermittent Bolus Nasogastric Feeding on Reducing Complications of Enteral Nutrition: A Meta-Analysis

OBJECTIVE: To systematically review the effects of enteral feeding pump and intermittent bolus nasogastric feeding on gastric retention, diarrhea, regurgitation, and other complications of patients who received enteral nutrition treatment. METHODS: We electronically searched databases including PubMed (1980-2013.9), Wiley Online Library (1990-2013.9), Elsevier (1990-2013.9), CNKI (1990-2013.9), VIP (1989-2013.9) and WanFang Data (1990-2013.9), to collect randomized controlled trials (RCTs) about enteral feeding pump and intermittent bolus nasogastric feeding. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data, and assessed the methodological quality of the included studies, and then meta-analysis was performed using RevMan 5.2.6 software. RESULTS: A total of 16 trials involving 1 263 patients were finally included. The results of meta-analysis indicated that enteral feeding pump was better than intermittent bolus nasogastric feeding in the incidences of gastric retention (OR=0.27, 95%CI 0.16 to 0.45, P<0.000 01), diarrhea (OR=0.24, 95%CI 0.16 to 0.34, P<0.000 01), regurgitation (OR=0.26, 95%CI 0.11 to 0.65, P=0.004), aspiration (OR=0.19, 95%CI 0.11 to 0.32, P<0.000 01), aspiration pneumonia (OR=0.40, 95%CI 0.23 to 0.68, P=0.000 7), and abdominal distension (OR=0.24, 95%CI 0.10 to 0.57, P=0.001), with significant differences. However, they were alike in the incidence of tub obstruction (OR=0.43, 95%CI 0.14 to 1.29, P=0.13). CONCLUSION: According to existing relevant RCTs, enteral feeding pump is better than intermittent bolus nasogastric feeding in reducing enteral nutrition complications to some extent. However, due to the low methodological quality of the included studies, more large-scale, multicentre high quality RCTs are still needed to verify the aforementioned conclusion.