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Improved Safety and Efficacy of Small-Bore Feeding Tube Confirmation Using an Electromagnetic Placement Device.
Nutr Clin Pract. 2018 Apr; 33(2):268-273.NC

Abstract

BACKGROUND

Early enteral nutrition has been shown to decrease complications and improve patient outcomes. Post pyloric feeding is recommended for patients with gastric intolerance or at high risk for aspiration. Feeding tube placement can be challenging and pose risk of pulmonary complications. Reliance on radiographic confirmation for feeding tube placement exposes the patient to radiation. Electromagnetic placement device (EMPD) may offer a method to minimize pulmonary complications, increase successful placement, and decrease radiation exposure to the patient.

OBJECTIVE

The purpose of this study was to evaluate the safety and efficacy of using EMPD verification, instead of routine abdominal radiographic confirmation, for small-bore feeding tube placement.

RESULTS

Variables evaluated were adverse events, utilization of radiographs for confirmation, and success rate of feeding tube placement in the ordered location. Two time frames were reviewed. In a 1-year period, 3754 small-bore feeding tubes were placed using EMPD, with zero adverse events noted. Radiographic confirmation was utilized in 0%-29.2% of the EMPD placed tubes. Successful placement of feeding tubes using EMPD ranged from 94%-99.6%. During a 5-year period, 7081 EMPD feeding tubes were evaluated. One adverse event, pneumothorax, occurred during the placement of these 7081 tubes, for a rate of 0.014%.

CONCLUSION

Feeding tube placement confirmation is safe and efficacious via EMPD providing an effective method of feeding tube placement with a success rate >94% into the desired location. EMPD is an accurate verification method of distal tip location, eliminating the need for routine abdominal radiographic confirmation.

Authors+Show Affiliations

Parkview Health System, Fort Wayne, Indiana, USA.Indiana University Health West Hospital, Avon, Indiana.Orlando Regional Medical Center, Orlando, Florida.Intermountain Medical Center, Salt Lake City, Utah.Sharp Chula Vista Medical Center, Chula Vista, California, USA.Indiana University Health Bloomington Hospital, Bloomington, Indiana.Intermountain Medical Center, Salt Lake City, Utah.TouchPoint, St. John Hospital & Medical Center, Detroit, Michigan, USA.B2S Consulting, Carmel, Indiana.

Pub Type(s)

Evaluation Study
Journal Article
Multicenter Study

Language

eng

PubMed ID

29529335

Citation

Powers, Jan, et al. "Improved Safety and Efficacy of Small-Bore Feeding Tube Confirmation Using an Electromagnetic Placement Device." Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition, vol. 33, no. 2, 2018, pp. 268-273.
Powers J, Luebbehusen M, Aguirre L, et al. Improved Safety and Efficacy of Small-Bore Feeding Tube Confirmation Using an Electromagnetic Placement Device. Nutr Clin Pract. 2018;33(2):268-273.
Powers, J., Luebbehusen, M., Aguirre, L., Cluff, J., David, M. A., Holly, V., Linford, L., Park, N., & Brunelle, R. (2018). Improved Safety and Efficacy of Small-Bore Feeding Tube Confirmation Using an Electromagnetic Placement Device. Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition, 33(2), 268-273. https://doi.org/10.1002/ncp.10062
Powers J, et al. Improved Safety and Efficacy of Small-Bore Feeding Tube Confirmation Using an Electromagnetic Placement Device. Nutr Clin Pract. 2018;33(2):268-273. PubMed PMID: 29529335.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Improved Safety and Efficacy of Small-Bore Feeding Tube Confirmation Using an Electromagnetic Placement Device. AU - Powers,Jan, AU - Luebbehusen,Michael, AU - Aguirre,Lillian, AU - Cluff,Julia, AU - David,Mary Ann, AU - Holly,Vince, AU - Linford,Lorraine, AU - Park,Nancy, AU - Brunelle,Rocco, Y1 - 2018/03/12/ PY - 2017/12/05/revised PY - 2018/3/13/pubmed PY - 2018/9/22/medline PY - 2018/3/13/entrez KW - enteral nutrition KW - feeding tube placement KW - nutritional support KW - patient safety KW - x-rays SP - 268 EP - 273 JF - Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition JO - Nutr Clin Pract VL - 33 IS - 2 N2 - BACKGROUND: Early enteral nutrition has been shown to decrease complications and improve patient outcomes. Post pyloric feeding is recommended for patients with gastric intolerance or at high risk for aspiration. Feeding tube placement can be challenging and pose risk of pulmonary complications. Reliance on radiographic confirmation for feeding tube placement exposes the patient to radiation. Electromagnetic placement device (EMPD) may offer a method to minimize pulmonary complications, increase successful placement, and decrease radiation exposure to the patient. OBJECTIVE: The purpose of this study was to evaluate the safety and efficacy of using EMPD verification, instead of routine abdominal radiographic confirmation, for small-bore feeding tube placement. RESULTS: Variables evaluated were adverse events, utilization of radiographs for confirmation, and success rate of feeding tube placement in the ordered location. Two time frames were reviewed. In a 1-year period, 3754 small-bore feeding tubes were placed using EMPD, with zero adverse events noted. Radiographic confirmation was utilized in 0%-29.2% of the EMPD placed tubes. Successful placement of feeding tubes using EMPD ranged from 94%-99.6%. During a 5-year period, 7081 EMPD feeding tubes were evaluated. One adverse event, pneumothorax, occurred during the placement of these 7081 tubes, for a rate of 0.014%. CONCLUSION: Feeding tube placement confirmation is safe and efficacious via EMPD providing an effective method of feeding tube placement with a success rate >94% into the desired location. EMPD is an accurate verification method of distal tip location, eliminating the need for routine abdominal radiographic confirmation. SN - 1941-2452 UR - https://www.unboundmedicine.com/medline/citation/29529335/Improved_Safety_and_Efficacy_of_Small_Bore_Feeding_Tube_Confirmation_Using_an_Electromagnetic_Placement_Device_ L2 - https://doi.org/10.1002/ncp.10062 DB - PRIME DP - Unbound Medicine ER -