Bedside placement of small-bowel feeding tube in Intensive Care Unit for enteral nutrition

Efficacy and safety of a modified method for blind bedside placement of post-pyloric feeding tube: a prospective preliminary clinical trial

Objective

To compare the efficacy and safety of a new modified method of bedside post-pyloric feeding tube catheterization with the Corpak protocol versus electromagnetic-guided catheterization.

Materials and Methods

We conducted a single-center, single-blinded, prospective clinical trial. Sixty-three patients were treated with a non-gravity type gastrointestinal feeding tube using different procedures: modified bedside post-pyloric feeding tube placement (M group), the conventional Corpak protocol (C group), and standard electromagnetic-guided tube placement (EM group).

Results

The success rate in the M group, C group, and EM group was 82.9% (34/41), 70.7% (29/41), and 88.2% (15/17), respectively, with significant differences among the groups. The time required to pass the pylorus was significantly shorter in the M group (26.9 minutes) than in the C group (31.9 minutes) and EM group (42.1 minutes). The proportion of pylorus-passing operations completed within 30 minutes was significantly higher in the M group than in the C group and EM group. No severe complications occurred.

Conclusion

This modified method of bedside post-pyloric feeding tube catheterization significantly shortened the time required to pass the pylorus with no severe adverse reactions. This method is effective and safe for enteral nutrition catheterization of patients with dysphagia and a high risk of aspiration pneumonia.

Nutrition Options in Critical Care Unit Patients

Critically ill patients have increased metabolic requirements and must rely on the administration of nutritional therapy to meet those demands. Yet, according to research almost half of all hospitalized patients are not fed, are underfed, or are malnourished while in the hospital. This article demonstrates the importance of early feedings in critical care unit, and the available options open to nurses supporting initiation and management of early feedings. Enteral nutrition has proven to be an important therapeutic strategy for improving the outcomes of critically ill patients and the critical care nurse plays an integral role in their success.