Abstract
Background: Existing trials have not evaluated the feasibility of oral or nasal feeding tube (FT) placement in the critically ill thrombocytopenic oncology population. Thrombocytopenia (TCP) may be considered a contraindication to FT placement due to the potential risk of bleeding complications. Methods: Medical intensive care unit (ICU) adult oncology patients with attempted nasal or oral FT placement were evaluated in a 52-bed ICU at a comprehensive cancer center. End points were compared between patients with and without TCP (platelet count <150,000/μL). Primary outcomes of overt and clinically important bleeding (gastrointestinal and point of entry) were evaluated within 72 hours of FT placement. Results: Fifty-nine patients were enrolled (TCP, n = 42; no TCP, n = 17; baseline platelet count, 41 ± 48 vs 249 ± 85 [× 103/μL], P <.001). Patients with TCP were more likely to have a hematologic malignancy and lower baseline hemoglobin and platelet count (P <.01). More patients with TCP received blood products 24 hours prior to FT placement (86% vs 12%, P <.01). There was no difference in overt (7.1% vs 0%, P =.55) or clinically important (2.4% vs 5.9%, P =.5) bleeding complications within 72 hours of attempted FT placement among patients with TCP versus those without. Conclusions: Critically ill oncology patients with TCP do not appear to be at a higher risk for bleeding complications after FT placement compared with those without TCP, which may be related to blood product transfusion within 24 hours prior to FT placement.
Original language | English (US) |
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Pages (from-to) | 111-115 |
Number of pages | 5 |
Journal | Nutrition in Clinical Practice |
Volume | 31 |
Issue number | 1 |
DOIs | |
State | Published - Feb 1 2016 |
Keywords
- critical care
- critical illness
- enteral nutrition
- hemorrhage
- oncology
- thrombocytopenia
ASJC Scopus subject areas
- Medicine (miscellaneous)
- Nutrition and Dietetics