Feasibility of post-operative enteral feeding using a nasojejunal tube in patients undergoing cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC)

ABSTRACT: Intervention participants will receive enteral feeding post-operatively via a nasojejunal gastric decompression tube placed intra-operatively. This tube will allow for simultaneous enteral feeding into the jejunum and gastric drainage. It is standard practice for all patients to receive a nasogastric tube during surgery which is usually used for gastric drainage only. Feeds will commence via the nasojejunal feeding port within 24hours of surgery using a standard polymeric enteral feed which is already used frequently throughout the hospital. Enteral feeds will run at 20mL/hr (equivalent to one tablespoon every hour) over 24 hours until post-operative day 3, after which the feed rate will be reviewed for increase. Nasogastric decompression will be managed as per the surgeon/intensive care unit (ICU) policy. If the participant has tolerated the feeds, the rate will be increased to 40ml/hour on post-operative day 3, 60ml/hour on post-operative day 5 and goal rate on post-operative day 7. Compliance to the intervention will be assessed and monitored through the audit of medical notes and standard observation charts. Parameters for feeding tolerance will be assessed using gastrointestinal and biochemical indicators including abdominal distension, vomiting, bloating, abdominal pain, nausea, C-Reactive protein, white blood cells, lactate and vital signs in discussion with the surgical and ICU team. Participants will also commence parenteral nutrition (PN) (current standard practice) at the same time the enteral nutrition starts. The combination of PN and enteral nutrition will meet the participant’s nutritional requirements as determined by the dietitian. PN rates will be increased operatively as per standard practice and then decreased if the rate of enteral feeding is increa Primary outcome(s): Feasibility of nasojejunal feeding post CRS and HIPEC. Feasibility will be defined as the ability to deliver at least 60ml/hour of enteral feeds via the NJ tube by post-operative day 6. This will be assessed using the medical record and fluid balance charts. [Post-operative day 6.];Complications of the nasojejunal-gastric decompression tube. This outcome will be assessed using the medical records.[End of intervention] Study Design: Purpose: Prevention; Allocation: Non-randomised trial; Masking: Open (masking not used);Assignment: Other;Type of endpoint: Efficacy

DISEASE(S): Cancer-ovarian And Primary Peritoneal,Cancer-bowel-back Passage (rectum) Or Large Bowel (colon),Peritoneal Surface Malignancy,Cancer

PROVIDER: 2473150 | ecrin-mdr-crc |

REPOSITORIES: ECRIN MDR