Enteral tube feeding for cystic fibrosis
Abstract
Background
Enteral tube feeding is routinely used in many cystic fibrosis centres when oral dietary and supplement intake has failed to achieve an adequate nutritional status. The use of this method of feeding is assessed on an individual basis taking into consideration the patients age and clinical status.
Objectives
To examine the evidence that in people with cystic fibrosis, supplemental enteral tube feeding improves nutritional status, respiratory function, and quality of life without significant adverse effects.
Search methods
We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register which comprises references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings. We also contacted the companies that market enteral feeds and reviewed their databases.
Date of the most recent search of the Group's Cystic Fibrosis Trials Register: 03 September 2012.
Date of the most recent hand search of PubMed and conference abstract books: 15 June 2012.
Selection criteria
All randomised controlled trials comparing supplemental enteral tube feeding for one month or longer with no specific intervention in people with cystic fibrosis.
Data collection and analysis
Thirty‐one trials were identified by the searches; however, none were eligible for inclusion in this review.
Main results
There are no trials included in this review.
Authors' conclusions
Supplemental enteral tube feeding is widely used throughout the world to improve nutritional status in people with cystic fibrosis. The methods mostly used, nasogastric or gastrostomy feeding, are expensive and may have a negative effect on self‐esteem and body image. Reported use of enteral tube feeding suggests that it results in nutritional and respiratory improvement; but, efficacy has not been fully assessed by randomised controlled trials. It is acknowledged, however, that performing a randomised controlled trial would be difficult due to the ethics of withholding an intervention in a group of patients whose nutritional status necessitates it.
PICOs
Plain language summary
Using tube feeding (via nose or stomach) in people with cystic fibrosis
Cystic fibrosis is an inherited condition which causes damage to the lungs and pancreas (an organ needed for the production of chemicals that help to digest food). People with cystic fibrosis often need a high energy diet in order to achieve a good nutritional status. To achieve this supplements are often given via a tube through the nose or stomach (enteral tube feeding). This type of feeding helps to improve weight gain, nutritional status, lung function and may improve quality of life. However, tube feeding is expensive and may impact on self‐esteem and body image. We have identified 28 trials in our searches, but none of these are randomised controlled trials showing the effects of enteral tube feeding. Hence no trials are included in the review. Ideally, more research is needed to compare tube feeding with oral supplements and with normal diet; also, trials should look at when tube feeding should be started for the best results. These trials may be difficult to do as it may be wrong not to provide extra calories in this way when needed.
