Quinteiro NM, Fioravanti Dos Santos J, de Siqueira Caldas JP, Carmona EV. Procedures for a Transpyloric Feeding Tube Inserted Into Newborns and Infants: A Systematic Review.
Adv Neonatal Care 2024;
24:374-381. [PMID:
38986126 DOI:
10.1097/anc.0000000000001172]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2024]
Abstract
BACKGROUND
Enteral feeding by a transpyloric tube in critically ill infants is indicated when there is a failure in gastric feeding. However, there is a wide variability regarding the insertion technique.
PURPOSE
To perform a systematic review of the methods for inserting a transpyloric feeding tube in newborns and infants.
DATA SOURCES
Nine databases, without date or language restrictions, accessed in September 2021.
STUDY SELECTION
A systematic review of experimental and nonexperimental studies, according to the "Patient/problem; Intervention; Comparison; Outcome" strategy and the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" guidelines. The clinical question was about the measurement and insertion techniques, as well as the success rates of properly placing a transpyloric tube in newborns and infants.
DATA EXTRACTION
Two authors (N.M.Q. and J.F.S.) analyzed 6 observational descriptive prospective studies, all of them published in peer-reviewed indexed medical journals and one in the official journal of the National Association of Neonatal Nurses.
RESULTS
The success rate varied between 70% and 100%. There was an important variability in the type of tube, measurement method, and insertion techniques. It was found that the most common strategies to achieve proper positioning were glabella-calcaneal measurements, gastric air insufflation, and right lateral decubitus.
IMPLICATIONS FOR PRACTICE
A transpyloric catheter insertion protocol needs to be established in each neonatal unit, according to the literature findings.
IMPLICATIONS FOR RESEARCH
Randomized controlled studies that evaluate the gastric air insufflation technique and other adjuvant measures could elucidate the knowledge gap concerning the correct positioning of transpyloric tubing in newborns and infants.
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