Jejunostomy tube feedings should not be stopped in the perioperative patient

Background: Anesthetic standard of care is to restrict oral intake for 8 ho urs before elective surgery. There is no research addressing appropriate pr eoperative discontinuation of jejunostomy tube (J-tube) feedings. We hypoth esized that patients could be fed safely, via a J-tube, until the time of s urgery. Methods: Patients admitted to a Level I Trauma Center, having J-tub es and undergoing a nonabdominal operation, were prospectively evaluated. G roup I patients received J-tube feedings until transport to the operating r oom. Group II patients had tube feedings discontinued for at least 8 hours before surgery. Data were compared using the Student's t test and contingen cy table analysis. Results: There were 46 patients in group I and 36 in gro up II. There was no incidence of aspiration. Patient groups did not differ in age, mortality, length of stay, injury severity score, or ventilator day s. Group I patients had tube feedings discontinued for fewer hours before a nd after surgery than group II patients (before surgery: 1.40 +/- 1.20 vs 1 1.61 +/- 5.01, respectively; p < .001; after surgery: 2.99 +/- 7.49 vs 7.11 +/- 9.03, respectively; p = .043); received more kilocalories/ grams of pr otein on the day of surgery (group I vs group II, 1676.15/89.57 +/- 1133.21 /38.04 vs 791.14/57.58 +/- 498.66/79.87, respectively; p = .001/p = .032) a nd more kilocalories/grams of protein on the first postoperative day (group I vs group II, 1580.74/92.57 +/- 600.53/37.96 vs 1152.47/63.53 +/- 733.96/ 39.40, respectively; p = .006/p = .001). Conclusions: Patients receiving J- tubes who are undergoing nonabdominal operations may safely continue entera l nutrition at maximum protein and caloric intake until surgery.