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A new technique for bedside placement of enteral feeding tubes: a prospective cohort study.
Crit Care. 2011; 15(1):R8.CC

Abstract

INTRODUCTION

To accomplish early enteral feeding in the critically ill patient a new transnasal endoscopic approach to the placement of postpyloric feeding tubes by intensive care physicians was evaluated.

METHODS

This was a prospective cohort study in 27 critically ill patients subjected to transnasal endoscopy and intubation of the pylorus. Attending intensive care physicians were trained in the handling of the new endoscope for transnasal gastroenteroscopy for two days. A jejunal feeding tube was advanced via the instrument channel and the correct position assessed by contrast radiography. The primary outcome measure was successful postpyloric placement of the tube. Secondary outcome measures were time needed for the placement, complications such as bleeding and formation of loops, and the score of the placement difficulty graded from 1 (easy) to 4 (difficult). Data are given as mean values and standard deviation.

RESULTS

Out of 34 attempted jejunal tube placements, 28 tubes (82%) were placed correctly in the jejunum. The duration of the procedure was 28 ± 12 minutes. The difficulty of the tube placement was judged as follows: grade 1: 17 patients, grade 2: 8 patients, grade 3: 7 patients, grade 4: 2 patients. In three cases, the tube position was incorrect, and in another three cases, the procedure had to be aborted. In one patient bleeding occurred that required no further treatment.

CONCLUSIONS

Fast and reliable transnasal insertion of postpyloric feeding tubes can be accomplished by trained intensive care physicians at the bedside using the presented procedure. This new technique may facilitate early initiation of enteral feeding in intensive care patients.

Authors+Show Affiliations

Department of Anaesthesiology and Intensive Care Medicine, University Medical Centre Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straβe, 24105 Kiel, Germany. zick@anaesthesie.uni-kiel.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21214907

Citation

Zick, Günther, et al. "A New Technique for Bedside Placement of Enteral Feeding Tubes: a Prospective Cohort Study." Critical Care (London, England), vol. 15, no. 1, 2011, pp. R8.
Zick G, Frerichs A, Ahrens M, et al. A new technique for bedside placement of enteral feeding tubes: a prospective cohort study. Crit Care. 2011;15(1):R8.
Zick, G., Frerichs, A., Ahrens, M., Schniewind, B., Elke, G., Schädler, D., Frerichs, I., Steinfath, M., & Weiler, N. (2011). A new technique for bedside placement of enteral feeding tubes: a prospective cohort study. Critical Care (London, England), 15(1), R8. https://doi.org/10.1186/cc9407
Zick G, et al. A New Technique for Bedside Placement of Enteral Feeding Tubes: a Prospective Cohort Study. Crit Care. 2011;15(1):R8. PubMed PMID: 21214907.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A new technique for bedside placement of enteral feeding tubes: a prospective cohort study. AU - Zick,Günther, AU - Frerichs,Alexander, AU - Ahrens,Markus, AU - Schniewind,Bodo, AU - Elke,Gunnar, AU - Schädler,Dirk, AU - Frerichs,Inéz, AU - Steinfath,Markus, AU - Weiler,Norbert, Y1 - 2011/01/07/ PY - 2010/11/10/received PY - 2010/12/13/revised PY - 2011/01/07/accepted PY - 2011/1/11/entrez PY - 2011/1/11/pubmed PY - 2011/12/13/medline SP - R8 EP - R8 JF - Critical care (London, England) JO - Crit Care VL - 15 IS - 1 N2 - INTRODUCTION: To accomplish early enteral feeding in the critically ill patient a new transnasal endoscopic approach to the placement of postpyloric feeding tubes by intensive care physicians was evaluated. METHODS: This was a prospective cohort study in 27 critically ill patients subjected to transnasal endoscopy and intubation of the pylorus. Attending intensive care physicians were trained in the handling of the new endoscope for transnasal gastroenteroscopy for two days. A jejunal feeding tube was advanced via the instrument channel and the correct position assessed by contrast radiography. The primary outcome measure was successful postpyloric placement of the tube. Secondary outcome measures were time needed for the placement, complications such as bleeding and formation of loops, and the score of the placement difficulty graded from 1 (easy) to 4 (difficult). Data are given as mean values and standard deviation. RESULTS: Out of 34 attempted jejunal tube placements, 28 tubes (82%) were placed correctly in the jejunum. The duration of the procedure was 28 ± 12 minutes. The difficulty of the tube placement was judged as follows: grade 1: 17 patients, grade 2: 8 patients, grade 3: 7 patients, grade 4: 2 patients. In three cases, the tube position was incorrect, and in another three cases, the procedure had to be aborted. In one patient bleeding occurred that required no further treatment. CONCLUSIONS: Fast and reliable transnasal insertion of postpyloric feeding tubes can be accomplished by trained intensive care physicians at the bedside using the presented procedure. This new technique may facilitate early initiation of enteral feeding in intensive care patients. SN - 1466-609X UR - https://www.unboundmedicine.com/medline/citation/21214907/A_new_technique_for_bedside_placement_of_enteral_feeding_tubes:_a_prospective_cohort_study_ L2 - https://ccforum.biomedcentral.com/articles/10.1186/cc9407 DB - PRIME DP - Unbound Medicine ER -