The incidence of aspiration pneumonia in acute ischemic stroke patients in relation to early insertion of nasogastric tube feeding

Abstract

Background Stroke is the acute onset of cerebral ischemia. Dysphagia with difficult swallowing is one of the common complications during the course of acute stroke, its incidence varies between 29–67%. Pneumonia is the second most common cause of death during the acute phase of stroke, with up to 20% mortality rate. In patient with risk of dysphagia or deficient oral intake, enteral feeding will be recommended. Objective Study the effect of early insertion of nasogastric tube for feeding on incidence of aspiration pneumonia in acute ischemic stroke patients with abnormal water swallow test. Methods The study was carried out in Alexandria Main University Hospital on 40 patients with acute ischemic stroke. Patients with abnormal water swallow test were classified into two groups: Group A: Insertion of nasogastric tube on admission after diagnosis. Group B: Giving intravenous fluids, minerals and traces for the first 48 h then inserting nasogastric tube on the third day. Results By comparing the patients in both groups, there was no statistical significant difference between them as regards; age, gender, comorbidities, and APACHE II score on admission. There was a statistical significant difference between both groups regarding fever, CRP level, WBCs, hypoxic index and the length of hospital stay. Conclusion Inserting Nasogastric tube insertion on admission in acute stroke patients may increase the incidence of aspiration pneumonia than being non-oral for 48 h before insertion on the third day as it affects the duration of ICU and hospital stay.