Intermittent tube feeding for stroke patients with dysphagia: a meta-analysis and systematic review

Background: Nutrition supports is essential to the prognosis of stroke patients with dysphagia. It's necessary to evaluate the effects and safety of intermittent tube feeding for stroke patients with dysphagia, to provide evidence for the management of dysphagia. Methods: Cochrane Library et al. databases were searched for randomized controlled trials (RCTs) on the intermittent tube feeding for stroke patients with dysphagia up to Feb 15, 2021. Bias risk assessment tool recommended by Cochrane was used for quality assessment, and Revman5.3 software was used for data analysis. Results: A total of 11 RCTs involving 762 stroke patients with dysphagia were included. Meta-analysis indicated that intermittent tube feeding could significantly increase the rate of dysphagia function improvement [odd ratio (OR) =5.22, 95% confidence interval (CI): 3.38-8.07], serum albumin level [mean difference (MD) =3.07, 95% CI: 1.65-4.49], hemoglobin level (MD =1.55, 95% CI: 1.19-1.95), prealbumin level (MD =1.79, 95% CI: 1.46-2.12), and reduce the incidence of aspiration pneumonia (OR =0.28, 95% CI: 0.15-0.53), incidence of aspiration (OR =0.27, 95% CI: 0.08-0.93) for stroke patients with dysphagia (all P<0.05), o significant difference in the triceps skinfold thickness (TSF) (MD =0.46, 95% CI: -0.24 to 1.19) and arm muscle circumference (MD =0.04, 95% CI: -0.28 to 0.36) between two groups were found (all P>0.05). Egger regression tests indicated that there was no publication bias between included RCTs (all P>0.05). Discussion: Intermittent tube feeding for stroke patients with dysphagia during the recovery period can not only ensure the nutritional supply, but also promote the recovery of swallowing function and reduce the occurrence of aspiration and aspiration associated pneumonia.