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Analysis of an electromagnetic tube placement device versus a self-advancing nasal jejunal device for postpyloric feeding tube placement.

Abstract：

BACKGROUND:Initiation of enteral feeding is an important part of the best practice model for critically ill patients. Although nasogastric feeding is appropriate for the majority of patients requiring short-term nutrition support, certain patients benefit greatly from postpyloric feeding. OBJECTIVE:To determine which of 2 specialized enteral tube systems achieved postpyloric placement on initial insertion attempt most efficiently. DESIGN:Retrospective study comparing the Tiger 2 tube (T2T) and Cortrak Enteral Access System (C-EAS). SETTING:Academic medical center, mixed intensive care unit (ICU). PATIENTS:All patients admitted to the ICU between 2009 and 2013 who had either a C-EAS or T2T placed. MEASUREMENTS:Success rate for postpyloric placement, congruency of real-time tube placement with x-ray confirmation for C-EAS, and complication rates. RESULTS:Seventy-one T2T and 74 C-EAS patients were included. The T2T was postpyloric 62% (44/71) of attempted placements. C-EAS was postpyloric 43% (32/74) of attempted placements (P = 0.03). C-EAS tracings accurately reflected chest x-ray findings 83% and 82% for postpyloric and non-postpyloric insertion, respectively. During the entire study period, no adverse events were recorded. CONCLUSION:Our institution evaluated 2 different systems designed to ensure postpyloric placement of a small bore feeding tube. No literature exists directly comparing the 2 systems. Our retrospective review, although limited, showed that the T2T was more effective at postpyloric placement on first attempt. Although 1 benefit of the C-EAS system may be real-time visualization, our practice showed this system to be user dependent, which likely led to less success with postpyloric placement.

journal_name

J Hosp Med

journal_title

Journal of hospital medicine

authors

Boyer N,McCarthy MS,Mount CA

doi

10.1002/jhm.2122

subject

Has Abstract

pub_date

2014-01-01 00:00:00

pages

23-8

issue

1

eissn

1553-5592

issn

1553-5606

journal_volume

9

pub_type

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