Trial reportMedical science monitor : international medical journal of experimental and clinical research2026
Impact of a Staged Enteral Nutrition Nursing Pathway Based on Dynamic Assessment of Tolerance and Aspiration Risk vs Usual Care on Feeding Intolerance in Older Adult Patients With Acute Ischemic Stroke and Dysphagia: A Single-Center Randomized Controlled Trial.
Trial report in Medical science monitor : international medical journal of experimental and clinical research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND Older adult patients with acute ischemic stroke have dysphagia and require early post-pyloric enteral nutrition, yet feeding intolerance and unstable energy delivery remain common, and practical pathways that integrate tolerance and aspiration risk are lacking. This trial evaluated whether a dual-axis staged nursing pathway, compared with usual care, was associated with lower feeding intolerance and better nutritional delivery. MATERIAL AND METHODS This single-center, parallel, 1: 1 randomized controlled trial enrolled older adult patients with acute ischemic stroke and dysphagia with post-pyloric nasoenteric tubes placed. The intervention group received a staged nursing pathway, and the control group received usual care. The primary outcome was 7-day feeding intolerance; secondary outcomes were time to ≥80% of target, target-achieving days, aspiration-related pneumonia, and safety. Analyses were intention-to-treat. RESULTS Compared with control, the intervention group had a lower 7-day risk of feeding intolerance (adjusted RR 0.61, 95% CI, 0.47-0.81; P=0.003); faster attainment of at least 80% of energy target (adjusted HR 1.65, log-rank P<0.001); target-achieving-day proportion was higher (difference 0.16, Holm-adjusted P=0.001); risk of aspiration-related pneumonia was lower (adjusted RR 0.54, Holm-adjusted P=0.041); and difference in feeding-related hypoxemia was not significant (P=0.189). No between-group differences were observed in tube displacement, upper gastrointestinal bleeding, or electrolyte disturbances (all P>0.05). Subgroup/sensitivity analyses were consistent. CONCLUSIONS A staged nursing pathway driven by dynamic dual-axis assessment was associated with lower feeding intolerance and earlier, more stable nutritional delivery in the context of post-pyloric feeding, without increasing short-term safety events.
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