Large-Scale Study of Oro-esophageal Feeding Versus Nasogastric Feeding for Swallowing Function and Airway Protection

Browse trials for

• Deglutition Disorders 707

Study arms

• Experimental
  Oro-esophageal Group

  Participants will receive oro-esophageal feeding plus rehabilitation therapy in accordance with stroke rehabilitation guidelines, with the specific content determined by the participating centers, for 14 days and being hospitalized.

  Dietary Supplement: Oro-esophageal Feeding · Behavioral: Rehabilitation care

• Active comparator
  Nasogastric Group

  Participants will receive Nasogastric feeding plus rehabilitation therapy in accordance with stroke rehabilitation guidelines, with the specific content determined by the participating centers, for 14 days and being hospitalized.

  Dietary Supplement: Nasogastric Feeding · Behavioral: Rehabilitation care

Interventions

• Dietary supplementOro-esophageal Feeding

  Medical staff inserts the tube slowly and smoothly into the upper esophagus, verifying the correct insertion depth by referencing the calibration marks on the tube wall. The distance from the incisors to the tube's tip should range from 22 to 25 cm. Following insertion, the distal end of the tube is submerged in a container of water, and the absence of continuous bubbling confirms successful intubation. Feeding is subsequently administered three times daily at a rate of 50 mL per minute, with a volume of 400 to 600 mL per feeding. The intervention period lasts for a total of two weeks.

• Dietary supplementNasogastric Feeding

  The feeding was conducted once every 3-4 hours, with 200-300ml each time. The total feeding volume was determined based on daily requirements. The feeding content was formulated by the nutritionists based on the patient condition and relevant guidelines to reach the energy demand as 20-35 kcal/kg/day and daily protein demand of patients through the determination of 24-h urinary urea for both two groups.The intervention period lasts for a total of two weeks.

• BehavioralRehabilitation care

  All patients will receive rehabilitation care according to the standard of care for the trial site hospital. All these interventions are performed in accordance with the Chinese Guidelines for Stroke Rehabilitation and the Chinese Guidelines for Dysphagia Rehabilitation. The intervention period lasts for a total of two weeks.

Primary outcomes

1. Dysphagia Outcome and Severity Scale

   The Dysphagia Outcome and Severity Scale consists of 7 levels, from 1 to 7, based on imaging data. A higher level indicates better swallowing function.

   Time frame: Day 0 and day15

Secondary outcomes

1. Time to improvement of one level and of the baseline Dysphagia Outcome and Severity Scale

   The Dysphagia Outcome and Severity Scale consists of 7 levels, from 1 to 7, based on imaging data. The investigators will record the time required for participants to achieve a one-grade improvement from the baseline Dysphagia Outcome and Severity Scale.

   Time frame: up to 2 weeks

2. Time to oral intake

   The time to recovery is the first day, during the two weeks of the intervention period, on which a participant meets level 3, 4, 5, 6, or 7 on the Dysphagia Outcome and Severity Scale. The Dysphagia Outcome and Severity Scale consists of 7 levels, from 1 to 7, based on imaging data. A higher level indicates better swallowing function.

   Time frame: up to 2 weeks

3. Penetration-Aspiration Scale

   The Penetration-Aspiration Scale is for assessing airway protection. It has 8 grades, grouped into 3 categories: no penetration/aspiration, penetration, aspiration. Lower grades = better function: Grade 1 is optimal (no airway entry); Grade 8 is most severe (food enters airway below vocal cords with no clearing effort).

   Time frame: Day 0 and day15

4. Murray Secretion Scale

   The Murray Secretion Scale is used to evaluate the accumulation of secretions, in which grade 0 meant no obvious accumulation, and grade 3 meant secretions in the laryngeal vestibule. The Murray Secretion Scale has 4 grades. The higher grade indicates more severe accumulation of secretions.

   Time frame: Day 0 and day15

5. Yale Pharyngeal Residual Severity Rating Scale

   The Yale Pharyngeal Residual Severity Rating Scale is used to evaluate pharyngeal residue after swallowing. The score could range between 1 and 5, with higher scores indicating worse situations.

   Time frame: Day 0 and day15

6. Aspiration

   Aspiration is based on self-reporting, caregiver monitoring, or the diagnosis of aspiration pneumonia, defined as the coughing and discomfort caused by food or water entering the airway for various reasons. The numbers of aspiration will be recorded.

   Time frame: up to 6 weeks

Publications

• Wang M, Xia C, Lu Y, Zeng H, Liu H, Zhao W, Wang L, Zeng X, Yang Y. Effects of oro-esophageal versus nasogastric feeding on dysphagia for ischemic stroke survivors: study protocol for a randomized controlled trial. Front Nutr. 2026 Apr 29;13:1830508. doi: 10.3389/fnut.2026.1830508. eCollection 2026. PubMed 42137858 ↗