Three retrospective cohort studies comparing patients with and without tube feeding demonstrated no advantage to tube feeding for this purpose. Swallowing studies, such as videofluoroscopy, lack both sensitivity and specificity in predicting who will develop aspiration pneumonia. In this study, no reduction in the incidence of pneumonia was demonstrated in those tube fed. Swallowing studies may be helpful in providing guidance regarding swallowing techniques for populations amenable to instruction. Numerous observational studies have been published, demonstrating a high incidence of aspiration pneumonia in those who have been tube fed.
Date is weakest in advanced cancer.
Non-randomized, retrospective studies have found no survival advantage in patients with dementia. A recent literature review using palliative care and enteral nutrition as search terms found no studies demonstrating improved quality of life through tube feeding. Tube feeding may adversely affect quality of life through increased need for physical restraints, infections, pain, indignity cost and the denial of the pleasure of eating. Summary Tube feeding should always be considered relative to patient goals. The Internal Medicine Residency Program has received a Pierson Faculty Visitation Award from the Joint Committee on Primary Care Rotations in Allergy .