Age differences in fluid balance and serum Na+ and K+ levels after nasogastric tube feeding in stroke patients: elderly vs nonelderly.

摘要

BACKGROUND: Enteral nutrition support has been commonly used to improve nutrition status in acute stroke patients. The purpose of this study was to examine whether significant alterations in fluid and serum Na+ and K+ levels due to nasogastric tube feeding depended on patient age. METHODS: This study was conducted by retrospective review of the medical records of tube-fed patients with acute brain infarction who had been hospitalized in a university hospital. RESULTS: Rates of overhydration were high before tube feeding in both elderly and nonelderly stroke patients. This overhydration rate became more prevalent after iso-osmolal tube feeding in the elderly but decreased somewhat in the nonelderly subjects, and this difference in fluid balance after tube feeding between the elderly and nonelderly was statistically significant. Contrary to fluid balance, serum Na+ and K+ concentrations were no different in the elderly and nonelderly patients after tube feeding. CONCLUSIONS: Although the results showed that overhydration state was prominent after tube feeding in the elderly, it appeared that there was a very mild clinical impact because the osmolality and serum sodium were not changed in this group. However, more attention to the maintenance of fluid balance in the elderly tube-fed stroke patients is needed because elderly patients have great difficulty in maintaining a normal fluid balance.