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Clinical Outcomes and Patient Safety of Nasogastric Tube in Acute Stroke Patients
Discussion with family prior to insertion of NGT recorded in 46 (18.4%). There were 123 cases (49.2%) of aspiration pneumonia. There were 188 (75.2%) NGT associated complications: 67 patients (26.8%) had failed insertion, 31 required multip le attempts, 129 patients (51.6%) pulled out NGT, 107 patients (42.8%) had NGT placed in wrong positions and require reinsertion, 20 cases in the lung, 5 pneumothorax cases, 97 in the gastro oesophageal junction or hiatus hernias, 1 case of oesophageal ulceration, 37 coiled, kinked or resistance. 78 cases the tips were not seen on chest X-ray (CXR), gastrointestinal bleeding in 9 cases,...
Source: Dysphagia - March 16, 2022 Category: Speech-Language Pathology Source Type: research

Monitoring of hospital acquired pneumonia in patients with severe brain injury on first access to intensive neurological rehabilitation: First year of observation.
Authors: Beghi G, De Tanti A, Serafini P, Bertolino C, Celentano A, Taormina G Abstract Nosocomial or hospital acquired pneumonia (HAP) is an illness contracted during a hospital stay, generally with onset 48 hours or more after admission to hospital, or within 14 days of discharge from hospital. HAP is divided into subgroups: Ventilator-associated pneumonia (VAP), accounting for 86% of hospital acquired pneumonia, and stroke-associated pneumonia (SAP). The incidence of SAP in neurological intensive care units (NICUs) is 4.1-56.6%, in medical intensive care units (MICUs) it is 17-50%, in stroke units it is 3.9-44% ...
Source: Monaldi Archives for Chest Disease - May 11, 2018 Category: Respiratory Medicine Tags: Monaldi Arch Chest Dis Source Type: research

Timing of Percutaneous Endoscopic Gastrostomy for Acute Ischemic Stroke Clinical Sciences
Background and Purpose—Stroke guidelines recommend time-limited trials of nasogastric feeding prior to percutaneous endoscopic gastrostomy (PEG) tube placement. We sought to describe timing of PEG placement and identify factors associated with early PEG for acute ischemic stroke.Methods—We designed a retrospective observational study to examine time to PEG for ischemic stroke admissions in the Nationwide Inpatient Sample, 2001 to 2011. We defined early PEG placement as 1 to 7 days from admission. Using multivariable regression analysis, we identified the effects of patient and hospital characteristics on PEG timing.Res...
Source: Stroke - January 22, 2017 Category: Neurology Authors: Benjamin P. George, Adam G. Kelly, George P. Albert, David Y. Hwang, Robert G. Holloway Tags: Health Services, Ischemic Stroke Original Contributions Source Type: research

Predictors of Nasogastric Tube Removal Before Acute Hospital Discharge in First-Ever Ischemic Stroke Patients
To identify the predictors of nasogastric tube (NGT) removal.
Source: Archives of Physical Medicine and Rehabilitation - September 27, 2016 Category: Rehabilitation Authors: Yun-Shan Yen, Willy Chou, Ya-Fang Hsu, Mei-Ju Ko, Daniel Chiung Jui Su, Wen-Chih Lin Source Type: research

All bleeding stops — but does idarucizumab (Praxbind) make it stop faster?
3.5 out of 5 stars Persistent life-threatening hemorrhage after administration of idarucizumab. Alhashem HM et al. Am J Emerg Med 2016 June 30 [Epub ahead of print] Reference Dabigatran (Pradaxa) is a direct thrombin inhibitor approved for stroke and embolism prophylaxis in patients with non-valve-related atrial fibrillation. When it was first released in 2008, a major disincentive to widespread use was the lack of a reliable reversal agent to treat major bleeds, or to administer before necessary invasive procedures. In October 2015, the U.S. Food and Drug Administration approved idarucizumab (Praxbind), a monoclonal ant...
Source: The Poison Review - July 27, 2016 Category: Toxicology Authors: Leon Gussow Tags: Medical anticoagulant hemorrhage idarucizumab pradaxa praxbind reversal agent Source Type: news

Enteral tube feeding for dysphagic stroke patients.
Abstract Enteral feeding tubes, a nasogastric tube (NGT) or percutaneous endoscopic gastrostomy (PEG), are commonly used to provide nutrition, hydration and essential medications to stroke patients who cannot swallow. Early tube feeding is associated with improved survival after stroke and it is recommended that patients start tube feeding within 24 hours of hospital admission. NGT feeding is the preferred method for short-term feeding in the acute phase of stroke as it has the advantage of being easily placed at the bedside. However, there are often difficulties inserting the NGT and it can be easily dislodged by...
Source: British Journal of Nursing - February 12, 2015 Category: Nursing Authors: Rowat A Tags: Br J Nurs Source Type: research

Case of the Month #181: Iatrogenic Colon Perforation During Epicardial Pacing Wire Placement
A 79-year-old man was admitted to the hospital with Staphylococcal aureus endocarditis. Before surgery, he had a small right hemispheric cardioembolic stroke. He subsequently underwent mitral valve replacement for treatment of a large posterior leaflet valvular vegetation. Two days after surgery, he clinically deteriorated and developed intolerance to nasogastric feeds and significant abdominal distension and tenderness. He was hemodynamically stable, without fever or increasing leukocytosis. Supine frontal chest and abdominal radiographs (not shown) were ordered and demonstrated postsurgical changes related to recent mitr...
Source: Canadian Association of Radiologists Journal - January 25, 2013 Category: Radiology Authors: Justin Haba, Shamir Patel, Robin Gray Tags: Canadian Residents’ Corner / Coin canadien des résidents en radiologie Source Type: research

Efficacy of Cilostazol in Preventing Aspiration Pneumonia in Acute Cerebral Infarction
This retrospective study examined the effectiveness of cilostazol in preventing aspiration pneumonia in patients with acute cerebral infarction. The 189 subjects ranged in age from 31 to 95 years and included 57 with small-artery occlusion, 107 with large-artery atherothrombosis, and 25 with other disorders. Patients with cardiogenic cerebral embolism or preexisting pneumonia at the time of hospital admission were excluded from the analysis. Neurologic symptoms, cognitive function, and swallowing function were assessed at the first clinical examination, and the ability to perform activities of daily living was assessed at ...
Source: Journal of Stroke and Cerebrovascular Diseases - August 9, 2012 Category: Neurology Authors: Aiko Osawa, Shinichiro Maeshima, Norio Tanahashi Tags: Original Articles Source Type: research