Is tube feeding associated with altered arterial oxygen saturation in stroke patients?

Background: Reduced arterial oxygen saturation (SaO(2)) during swallowing, oral feeding and feeding tube placement has been demonstrated in stroke patients. It is not known if tube feeding causes similar episodes of arterial desaturation and whether there is a case for routine pulse oximetry during tube feeding.

Objective: To determine if tube feeding in stroke patients is associated with hypoxia.

Methods: We compared ischaemic or haemorrhagic stroke patients who were NG or PEG fed with a control group of age matched non-dysphagic stroke patients who were orally fed. We excluded people already on supplemental oxygen. Pulse oximetry was performed before, during a meal (for 20 min) and for 10 min after and changes from baseline readings determined.

Results: Data were collected for 20 controls and 18 tube-fed patients. Mean age was 75 years and median time to assessment 14.5 days. The two groups were reasonably matched for age, sex, type of stroke and time to assessment, but differed significantly in the Oxfordshire Community Stroke Project (OCSP) classification and Rankin score. The mean baseline SaO(2) of controls was 96.5% (SD 1.47) and that of the tube-fed group 96.0% (SD 1.46). Reduction in SaO(2) from baseline during and after feeding ranged from 0.35% to 0.78% with no statistically or clinically significant differences between the two groups.

Conclusions: No clinically significant reduction in SaO(2) was found in our tube-fed patients as compared to controls. Our study suggests that routine pulse oximetry during tube feeding is not necessary.