Is overnight tube feeding associated with hypoxia in stroke?
SIR Dysphagia is found in about 45% of patients who have had a stroke [1], and nasogastric (NG) or percutaneous endoscopic gastrostomy (PEG) tubes are often used for enteral nutrition. The insertion of an NG or PEG tube in stroke patients has been associated with a modest drop in arterial oxygen saturation (SaO2) [2]. In a study of NG tube-fed patients with chronic obstructive airways disease, there was a small drop in SaO2 associated with feeding [3]. Reduced SaO2 during swallowing and oral feeding has also been demonstrated in stroke [4 6]. However, it is not known whether tube feeding in stroke patients leads to significant episodes of arterial desaturation and whether there is a case for routine pulse oximetry or supplemental oxygen during tube feeding. A study that compared SaO2 during a 30 min period of tube feeding with orally fed stroke controls found a very small but statistically significant change in SaO2 in tube-fed patients [7]. The detection of hypoxia following a stroke
