Evidence map›Paper›PMID 31733618›Full record

ArticleInternational journal of surgery case reports2019

A case of tracheal obstruction caused by reflux and aspiration of semi-solid nutrients via the nasogastric tube.

Masatoshi Nakagawa, Kaori Sugihara, Kiyoshi Isobe, Masafumi Akasu, Kazutaka Tsujimoto, Yasuhiro Itsui, Yasuaki Nakajima

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in International journal of surgery case reports, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.1field-weighted citation impact, top 48% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Masatoshi NakagawaDepartment of Gastrointestinal Surgery, Tokyo Medical and Dental University, Japan; Department of Clinical Nutrition, Tokyo medical and Dental University, Japan. Electronic address: nakagawa.srg1@tmd.ac.jp.
Kaori SugiharaDepartment of Clinical Nutrition, Tokyo medical and Dental University, Japan.
Kiyoshi IsobeDepartment of Clinical Nutrition, Tokyo medical and Dental University, Japan; Department of Nephrology, Tokyo Medical and Dental University, Japan.
Masafumi AkasuDepartment of Clinical Nutrition, Tokyo medical and Dental University, Japan; Department of Hepato-Biliary-Pancreatic Surgery, Tokyo Medical and Dental University, Japan.
Kazutaka TsujimotoDepartment of Clinical Nutrition, Tokyo medical and Dental University, Japan; Department of Molecular Endocrinology and Metabolism, Tokyo Medical and Dental University, Japan.
Yasuhiro ItsuiDepartment of Clinical Nutrition, Tokyo medical and Dental University, Japan; Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Japan.
Yasuaki NakajimaDepartment of Gastrointestinal Surgery, Tokyo Medical and Dental University, Japan; Department of Clinical Nutrition, Tokyo medical and Dental University, Japan.
Tokyo Medical and Dental University · JPTokyo Medical and Dental University Hospital · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionSemi-solid nutrients have several advantages, including reduced cases of diarrhea and aspiration pneumonia, and are usually administered via percutaneous endoscopic gastrostomy owing to its high viscosity. Administering semi-solid nutrients via a nasogastric tube was recently introduced in clinical practice; however, its safety has not been well confirmed. PRESENTATION OF CASE: An 82-year-old man with a right occipital hemorrhage and severe diarrhea consulted the nutritional support team. Administrations of semi-solid nutrients (HINE E-GEL®) via the nasogastric tube was initiated, which gradually alleviated his symptoms. Fourteen days after initiation, he suddenly had pulmonary failure owing to a tracheal obstruction caused by the reflux and aspiration of semi-solid nutrients. Intubation and subsequent reflex cough expectorated sputum with gel-form particles, which quickly stabilized his pulmonary condition. After this, his hospital course was stable, and he was referred to another hospital for further rehabilitation. DISCUSSION: Semi-solid nutrients administered via the nasogastric tube have different ingredients compared with those administered via percutaneous endoscopic gastrostomy. HINE E-GEL®, for example, contains pectin and calcium phosphate that changes from liquid to semi-solid inside the stomach via chemical reactions under acidic conditions. Data on the viscosity of HINE E-GEL® in vivo are insufficient. Uncertainty regarding the form and viscosity of HINE E-GEL® inside the stomach complicates clinical practice.

conclusionsAlthough semi-solid nutrients have several advantages, including reduced diarrhea and gastroesophageal reflux, evidence on semi-solid nutrients via the nasogastric tube is insufficient. It should be noted that semi-solid nutrient reflux can be more fatal than liquid nutrients.

Indexed as

Case reportEnteral feedingNasogastric tubeSemi-solid nutrientsTracheal obstruction

Identifiers

PMID31733618
PMCPMC6864173
OpenAlexW2988232242

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.