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Use of small-bore feeding tubes: successes and failures.
Curr Opin Clin Nutr Metab Care. 2007 May; 10(3):291-6.CO

Abstract

PURPOSE OF REVIEW

Early enteral nutrition is the preferred option for feeding patients who cannot meet their nutrient requirements orally. This article reviews complications associated with small-bore feeding tube insertion and potential methods to promote safe gastric or postpyloric placement. We review the available bedside methods to check the position of the feeding tube and identify inadvertent misplacements.

RECENT FINDINGS

Airway misplacement rates of small feeding tubes are considerable. Bedside methods (auscultation, pH, aspirate appearance, air bubbling, external length of the tube, etc.) to confirm the position of a newly inserted small-bore feeding tube have limited scientific basis. Radiographic confirmation therefore continues to be the most accurate method to ascertain tube position. Fluoroscopic and endoscopic methods are reliable but costly and are not available in many hospitals. Rigid protocols to place feeding tubes along with new emerging technology such as CO2 colorimetric paper and tubes coupled with signaling devices are promising candidates to substitute for the blind placement method.

SUMMARY

The risk of misplacement with blind bedside methods for small-bore feeding tube insertion requires a change in hospital protocols.

Authors+Show Affiliations

Department of Surgery, Federal University of Mato Grosso, Rua Estevão de Mendonça 81, Cuiabá, MT 78043-300, Brazil. aguilar@terra.com.brNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

17414497

Citation

de Aguilar-Nascimento, José Eduardo, and Kenneth A. Kudsk. "Use of Small-bore Feeding Tubes: Successes and Failures." Current Opinion in Clinical Nutrition and Metabolic Care, vol. 10, no. 3, 2007, pp. 291-6.
de Aguilar-Nascimento JE, Kudsk KA. Use of small-bore feeding tubes: successes and failures. Curr Opin Clin Nutr Metab Care. 2007;10(3):291-6.
de Aguilar-Nascimento, J. E., & Kudsk, K. A. (2007). Use of small-bore feeding tubes: successes and failures. Current Opinion in Clinical Nutrition and Metabolic Care, 10(3), 291-6.
de Aguilar-Nascimento JE, Kudsk KA. Use of Small-bore Feeding Tubes: Successes and Failures. Curr Opin Clin Nutr Metab Care. 2007;10(3):291-6. PubMed PMID: 17414497.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Use of small-bore feeding tubes: successes and failures. AU - de Aguilar-Nascimento,José Eduardo, AU - Kudsk,Kenneth A, PY - 2007/4/7/pubmed PY - 2007/6/26/medline PY - 2007/4/7/entrez SP - 291 EP - 6 JF - Current opinion in clinical nutrition and metabolic care JO - Curr Opin Clin Nutr Metab Care VL - 10 IS - 3 N2 - PURPOSE OF REVIEW: Early enteral nutrition is the preferred option for feeding patients who cannot meet their nutrient requirements orally. This article reviews complications associated with small-bore feeding tube insertion and potential methods to promote safe gastric or postpyloric placement. We review the available bedside methods to check the position of the feeding tube and identify inadvertent misplacements. RECENT FINDINGS: Airway misplacement rates of small feeding tubes are considerable. Bedside methods (auscultation, pH, aspirate appearance, air bubbling, external length of the tube, etc.) to confirm the position of a newly inserted small-bore feeding tube have limited scientific basis. Radiographic confirmation therefore continues to be the most accurate method to ascertain tube position. Fluoroscopic and endoscopic methods are reliable but costly and are not available in many hospitals. Rigid protocols to place feeding tubes along with new emerging technology such as CO2 colorimetric paper and tubes coupled with signaling devices are promising candidates to substitute for the blind placement method. SUMMARY: The risk of misplacement with blind bedside methods for small-bore feeding tube insertion requires a change in hospital protocols. SN - 1363-1950 UR - https://www.unboundmedicine.com/medline/citation/17414497/Use_of_small_bore_feeding_tubes:_successes_and_failures_ L2 - http://dx.doi.org/10.1097/MCO.0b013e3280d64a1d DB - PRIME DP - Unbound Medicine ER -