Gastric-tube versus post-pyloric feeding in critical patients: a systematic review and meta-analysis of pulmonary aspiration- and nutrition-related outcomes

Gastric-tube feeding and post-pyloric feeding are the two most common forms of enteral nutrition, each with advantages and disadvantages. To explore the effects and safety of gastric-tube versus post-pyloric feeding in critical patients by comparing pulmonary aspiration- and nutrition-related outcomes, a meta-analysis was conducted. It was performed by systematically searching the following databases: PubMed, EMBASE, Cochrane library, BMJ best practice, ProQuest dissertations and theses, CINAHL, web of science, SinoMed, WANFANG, CNKI, and the platform of clinical trial registration. The databases were searched through December 31, 2019, and studies were evaluated by two independent researchers. Review Manager software was used for data analysis. We included 41 studies conducted in ten countries and involving 3248 participants. Meta-analysis showed that post-pyloric feeding had a lower incidence rate of pulmonary aspiration, gastric reflux, and pneumonia ( P