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Endoscopic placement of nasoenteric feeding tubes in critically ill patients: a reliable alternative.
J Laparoendosc Adv Surg Tech A. 1998 Dec; 8(6):395-400.JL

Abstract

Spontaneous transpyloric passage of nasoenteric feeding tubes is often unsuccessful in critically ill patients due to gastric ileus. The purpose of this study was to evaluate the success rate of endoscopic placement of postpyloric nasoenteric tubes and the time required to achieve goal enteral nutritional support in critically ill patients with gastric ileus. Surgical ICU patients with gastric ileus, documented by recorded high gastric residual volumes via a nasogastric tube, were identified for placement of a nasoenteric postpyloric tube via esophagogastroduodenoscopy (EGD). EGD was performed bedside in the ICU, using intravenous sedation, for placement of a 43-inch (109 cm) 8 French tungsten-weighted nasoenteric tube with an inner stylet into the duodenum, and the tube was advanced as far distally as possible. Abdominal radiograph was obtained to confirm final tube position postprocedure. Enteral feedings were initiated immediately with a full-strength formula and increased to the goal enteral feeding rate as tolerated. Thirty-four patients underwent successful placement of postpyloric nasoenteric tubes by EGD. One procedure was aborted in a patient with adult respiratory distress syndrome (ARDS) who developed hypoxemia with gastric insufflation during the EGD. The mean time to achievement of goal enteral nutritional support was 20.8 hours. Tubes remained in place for a range of 6 to 37 days. Endoscopic placement of postpyloric enteral feeding tubes is highly successful, and allows for prompt achievement of goal enteral nutritional requirements. It has two main advantages: it eliminates the risk of patient travel to radiology for fluoroscopic placement, and allows for earlier initiation of enteral feedings because spontaneous passage of weighted nasoenteric tubes into the duodenum in critically ill patients is often unsuccessful.

Authors+Show Affiliations

Department of Surgery, University of Maryland Medical Center, Baltimore, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

9916592

Citation

Napolitano, L M., et al. "Endoscopic Placement of Nasoenteric Feeding Tubes in Critically Ill Patients: a Reliable Alternative." Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A, vol. 8, no. 6, 1998, pp. 395-400.
Napolitano LM, Wagle M, Heard SO. Endoscopic placement of nasoenteric feeding tubes in critically ill patients: a reliable alternative. J Laparoendosc Adv Surg Tech A. 1998;8(6):395-400.
Napolitano, L. M., Wagle, M., & Heard, S. O. (1998). Endoscopic placement of nasoenteric feeding tubes in critically ill patients: a reliable alternative. Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A, 8(6), 395-400.
Napolitano LM, Wagle M, Heard SO. Endoscopic Placement of Nasoenteric Feeding Tubes in Critically Ill Patients: a Reliable Alternative. J Laparoendosc Adv Surg Tech A. 1998;8(6):395-400. PubMed PMID: 9916592.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Endoscopic placement of nasoenteric feeding tubes in critically ill patients: a reliable alternative. AU - Napolitano,L M, AU - Wagle,M, AU - Heard,S O, PY - 1999/1/23/pubmed PY - 1999/1/23/medline PY - 1999/1/23/entrez SP - 395 EP - 400 JF - Journal of laparoendoscopic & advanced surgical techniques. Part A JO - J Laparoendosc Adv Surg Tech A VL - 8 IS - 6 N2 - Spontaneous transpyloric passage of nasoenteric feeding tubes is often unsuccessful in critically ill patients due to gastric ileus. The purpose of this study was to evaluate the success rate of endoscopic placement of postpyloric nasoenteric tubes and the time required to achieve goal enteral nutritional support in critically ill patients with gastric ileus. Surgical ICU patients with gastric ileus, documented by recorded high gastric residual volumes via a nasogastric tube, were identified for placement of a nasoenteric postpyloric tube via esophagogastroduodenoscopy (EGD). EGD was performed bedside in the ICU, using intravenous sedation, for placement of a 43-inch (109 cm) 8 French tungsten-weighted nasoenteric tube with an inner stylet into the duodenum, and the tube was advanced as far distally as possible. Abdominal radiograph was obtained to confirm final tube position postprocedure. Enteral feedings were initiated immediately with a full-strength formula and increased to the goal enteral feeding rate as tolerated. Thirty-four patients underwent successful placement of postpyloric nasoenteric tubes by EGD. One procedure was aborted in a patient with adult respiratory distress syndrome (ARDS) who developed hypoxemia with gastric insufflation during the EGD. The mean time to achievement of goal enteral nutritional support was 20.8 hours. Tubes remained in place for a range of 6 to 37 days. Endoscopic placement of postpyloric enteral feeding tubes is highly successful, and allows for prompt achievement of goal enteral nutritional requirements. It has two main advantages: it eliminates the risk of patient travel to radiology for fluoroscopic placement, and allows for earlier initiation of enteral feedings because spontaneous passage of weighted nasoenteric tubes into the duodenum in critically ill patients is often unsuccessful. SN - 1092-6429 UR - https://www.unboundmedicine.com/medline/citation/9916592/Endoscopic_placement_of_nasoenteric_feeding_tubes_in_critically_ill_patients:_a_reliable_alternative_ L2 - https://www.liebertpub.com/doi/full/10.1089/lap.1998.8.395?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -