FNCE 2023
Session 357. Providing MNT for the Pediatric Type 1 Diabetes Population: What Does the Evidence Show?
Monday, October 9, 8:30 AM - 9:30 AM
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  • Assessment
    In what critically ill patients might small bowel feeding tube placement be most useful?
    • Conclusion

      Small bowel feeding tube placement may not be necessary or feasible for all critically ill patients, but may be useful in high risk critically ill patients (supine positioning, sedation, and/or patients with large GRVs).

    • Grade: IV
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
  • Intervention
    Does the site of enteral feeding tube tip in the gastric vs. small bowel position impact infectious complications (aspiration pneumonia) in critically ill patients ?
    • Conclusion

      Adequately powered trials have not been conducted to test whether post-pyloric EN reduces aspiration pneumonia in critically ill patients. Several underpowered trials suggest there is no difference in aspiration by tube position in critically ill patients.

    • Grade: III
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    Does the site of enteral feeding tube tip in the gastric vs. small bowel position impact LOS in critically ill patients?
    • Conclusion

      To date, adequately powered studies have not been conducted to demonstrate a significant difference in LOS when comparing gastric vs. small bowel feeding tube position in critically ill patients .

    • Grade: V
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
  • Monitoring and Evaluation
    Does the site of enteral feeding tube tip in the gastric vs. small bowel position impact mortality in critically ill patients?
    • Conclusion

      To date, adequately powered studies have not been conducted to demonstrate a significant difference in mortality when comparing gastric versus small bowel feeding tube position in critically ill patients.

    • Grade: V
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    Does the site of enteral feeding tube tip in the gastric vs. small bowel position impact cost of medical care in critically ill patients?
    • Conclusion

      Any evaluation of the impact of feeding tube tip placement on the cost of medical care in critically ill patients was not yet located.

    • Grade: V
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.