Nasal/Oral Feeding Tube Insertion

2016 ◽  
pp. 101-104
Author(s):  
Bedros Taslakian
Keyword(s):  
Feeding Tube ◽  
Oral Feeding ◽  
Tube Insertion

scholarly journals Predicting feeding-tube dependence in patients following endotracheal extubation: a two-item swallowing screen

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shu-Fen Siao ◽  
Wen-Hsuan Tseng ◽  
Tyng-Guey Wang ◽  
Yu-Chung Wei ◽  
Tzu-Yu Hsiao ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Feeding Tube ◽  
Oral Feeding ◽  
Invasive Ventilation ◽  
Endoscopic Evaluation ◽  
Icu Patients ◽  
Cough Reflex ◽  
Risk Patients ◽  
To Receive ◽  
Endotracheal Extubation

Abstract Background To meet the surging demands for intubation and invasive ventilation as more COVID-19 patients begin their recovery, clinicians are challenged to find an ultra-brief and minimally invasive screen for postextubation dysphagia predicting feeding-tube dependence persisting for 72 h after extubation. Methods This study examined the predictive validity of a two-item swallowing screen on feeding-tube dependence over 72 h in patients following endotracheal extubation. Intensive-care-unit (ICU) patients (≥ 20 years) successfully extubated after ≥ 48 h endotracheal intubation were screened by trained nurses using the swallowing screen (comprising oral stereognosis and cough-reflex tests) 24 h postextubation. Feeding-tube dependence persisting for 72 h postextubation was abstracted from the medical record by an independent rater. To verify the results and cross-check whether the screen predicted penetration and/or aspiration during fiberoptic endoscopic evaluation of swallowing (FEES), participants agreeing to receive FEES were analyzed within 30 min of screening. Results The results showed that 95/123 participants (77.2%) failed the screen, which predicted ICU patients’ prolonged (> 72 h) feeding-tube dependence, yielding sensitivity of 0.83, specificity of 0.35, and accuracy of 0.68. Failed-screen participants had 2.96-fold higher odds of feeding-tube dependence (95% CI, 1.13–7.76). For the 38 participants receiving FEES, the swallowing screen had 0.89 sensitivity to detect feeding-tube dependence and 0.86 sensitivity to predict penetration/aspiration, although specificity had room for improvement (0.36 and 0.21, respectively). Conclusion This ultra-brief swallowing screen is sufficiently sensitive to identify high-risk patients for feeding-tube dependence persisting over 72 h after extubation. Once identified, a further assessment and care are indicated to ensure the prompt return of patients’ oral feeding. Trial registration NCT03284892, registered on September 15, 2017.

scholarly journals Erythromycin for Promoting the Postpyloric Placement of Feeding Tubes: A Systematic Review and Meta-Analysis

2018 ◽  
Vol 2018 ◽  
pp. 1-8
Author(s):  
Qing-Jun Jiang ◽  
Cai-Feng Jiang ◽  
Qi-Tong Chen ◽  
Jian Shi ◽  
Bin Shi
Keyword(s):  
Systematic Review ◽  
Adverse Effects ◽  
Success Rate ◽  
Meta Analysis ◽  
Feeding Tube ◽  
Tube Placement ◽  
Intravenous Route ◽  
Tube Insertion ◽  
Feeding Tubes ◽  
Feeding Tube Placement

Background. Critically ill patients can benefit from enteral nutrition with postpyloric feeding tubes, but the low success rate limits its wide use. Erythromycin could elevate the success rate of tube insertion, but its clinical efficiency still remains controversial. Methods. Included studies must be RCTs which assessed the success rate of postpyloric feeding tube insertion using erythromycin. Results. 284 patients were enrolled in six studies. Meta-analysis showed that erythromycin significantly increases the rate of successful postpyloric feeding tube placement (RR 1.45, 95% CI (1.12, 1.86)) and did not increase the risk of adverse effects (RR 2.15, 95% CI (0.20, 22.82)). Subgroup analysis showed that unweighted feeding tubes (RR 1.47, 95% CI (1.03, 2.11)) could significantly increase the success rate. Country of study, intravenous route of erythromycin, and year of participant enrollment did not influence these results. Conclusions. Erythromycin significantly increases the success rate of postpyloric feeding tube placement. This suggests that erythromycin can be used as an auxiliary method to improve the success rate of bedside insertion.

Endoscopic Insertion of Nasojejunal Feeding Tube at Bedside for Critically Ill Patients: Relationship between Tube Position and Intragastric Countercurrent of Contrast Medium

2019 ◽  
Vol 75 (3) ◽  
pp. 163-167
Author(s):  
Hiroomi Tatsumi ◽  
Masayuki Akatsuka ◽  
Satoshi Kazuma ◽  
Yoichi Katayama ◽  
Yuya Goto ◽  
...  
Keyword(s):  
Contrast Medium ◽  
Feeding Tube ◽  
Tube Insertion ◽  
Abdominal Radiography ◽  
Feeding Tubes ◽  
Tube Position ◽  
Endoscopic Insertion ◽  
Endoscopic Placement ◽  
Nasojejunal Feeding ◽  
Enteral Nutrients

Background and Oblectives: We evaluated the success rate of endoscopically positioned nasojejunal feeding tubes and the intragastric countercurrent of contrast medium thereafter. Method: This retrospective observational study investigated patients who were admitted to a single intensive care unit and required endoscopic placement of a post-pyloric feeding tube between January 2010 and June 2016. The feeding tube was grasped with forceps via a transoral endoscope and inserted into the duodenum or jejunum. Thereafter, we assessed the position of the tube and the intragastric countercurrent using abdominal radiography with contrast medium. Results: The tube tip was inserted at the jejunum and the duodenal fourth portion in 55.8 and 33.6% of patients, respectively. The tip of the inserted tube had moved into the jejunum of 71.7% of patients by the following day. The countercurrent rate was significantly lower among patients with a tube inserted into the duodenal fourth portion or more distal than among those with tubes inserted more proximally (8.4 vs. 45.4%, p = 0.0022). Conclusions: The endoscopic insertion and positioning of a nasojejunal feeding tube seemed effective because the rate of tube insertion into the duodenal fourth portion or more distal was about 90%. The findings of intragastric countercurrents indicated that feeding tubes should be inserted into the duodenal fourth portion or beyond to prevent vomiting and the aspiration of enteral nutrients.

scholarly journals Evaluation of the profile of drug therapy administered through enteral feeding tube in a general hospital in Rio de Janeiro

2011 ◽  
Vol 47 (2) ◽  
pp. 331-337 ◽  
Author(s):  
Mario Jorge Sobreira da Silva ◽  
Carlos Eduardo Meireles Cava ◽  
Patrícia Kaiser Pedroso ◽  
Débora Omena Futuro
Keyword(s):  
Drug Therapy ◽  
Enteral Feeding ◽  
Rio De Janeiro ◽  
Clinical Status ◽  
Nutritional Therapy ◽  
Feeding Tube ◽  
Oral Feeding ◽  
Enteral Feeding Tube ◽  
Effective Use ◽  
Recommended Guidelines

Enteral nutrition (EN) is the method of choice for patients that cannot adequately receive oral feeding despite good gastrointestinal tract condition. Enteral diets may be administered through tube or ostomy placed in the stomach, duodenum or jejunum. The administration of drugs via enteral feeding tube (EFT) is a common practice in hospitals due to patient clinical status, and requires special attention from professionals involved in this process. This study entailed an analysis of the profile of drug therapy through EFT based on evaluation of medical prescriptions of the Medical Clinic of the Hospital dos Servidores do Estado (HSE) of Rio de Janeiro sent to the Pharmacy Service between January and June 2007, according to standard protocols in place. Prescription of drugs via EFT outside recommended guidelines was observed, besides potential drug-nutrient incompatibilities associated with this practice. These results point to the need for improvement of enteral route access and the adoption of measures to promote safe and effective use of drugs and nutritional therapy.

scholarly journals Gastrostomy Tube Placement by Radiological versus Endoscopic Methods in an Acute Care Setting: A Retrospective Review of Frequency, Indications, Complications and Outcomes

2009 ◽  
Vol 23 (2) ◽  
pp. 109-114 ◽  
Author(s):  
Amy Galaski ◽  
Wei Wei Peng ◽  
Michelle Ellis ◽  
Pauline Darling ◽  
Andrew Common ◽  
...  
Keyword(s):  
Patient Characteristics ◽  
Feeding Tube ◽  
Tube Placement ◽  
Tube Insertion ◽  
Endoscopic Gastrostomy ◽  
Cost Differential ◽  
Gastrostomy Tube Placement ◽  
Group 3 ◽  
Percutaneous Radiological Gastrostomy ◽  
Endoscopic Methods

OBJECTIVES: To describe the current practice of placing gastrostomy tubes (endoscopic and radiological), patient characteristics, indications for enteral support, complications and outcomes over a 13-month period, and explore factors that influenced complications and outcomes. Second, to provide Canadian data regarding feeding tube placement because no current literature reflecting these practices for Canadian hospitals is available.METHODS: Retrospective chart reviews were conducted. Patients who had initial percutaneous endoscopic gastrostomy (PEG) or percutaneous radiological gastrostomy (PRG) tubes inserted for nutritional purposes were included in the study.RESULTS: A total of 136 charts which included 30 PEG and 44 PRG procedures were reviewed. The PRG group was older than the PEG group (mean [± SD] age 68±19 years versus 55±21 years, respectively; P=0.008). Patients in PEG group had longer lengths of hospital stay and more intensive care unit admissions than the PRG group (P=0.029). The main reason for tube insertion was dysphagia/aspiration (PEG [60%] and PRG [77%]). Minor complications were comparable between the two groups (P=0.678). There were three cases of major complications overall. More subjects in the PRG group died (18%) while in hospital than in the PEG group (3%) (P=0.055). No procedure-related deaths occured in either group.CONCLUSIONS: Both methods of tube insertion provided a safe route for nutrition delivery despite a significant cost differential with PEGs costing 44% more than PRGs. Characteristics such as age, presence of ascites and severity of disease influenced the method of insertion despite the lack of current guidelines. Overall, the present study provides new descriptive data in a Canadian context.

scholarly journals PTH-131 Endoscopic Gastropexy And Peg Feeding Tube Insertion: A Comparative Study: Abstract PTH-131 Table 1

Gut ◽  
2014 ◽  
Vol 63 (Suppl 1) ◽  
pp. A269.1-A269
Author(s):  
SS Salunke ◽  
R McKay ◽  
D Barber ◽  
AW McKinlay ◽  
JS Leeds
Keyword(s):  
Comparative Study ◽  
Feeding Tube ◽  
Tube Insertion ◽  
Peg Feeding Tube

Entral feeding tube insertion after esophagectomy: Technique via transgastric conduit or transduodenal.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 210-210
Author(s):  
Takashi Ogata ◽  
Tetsushi Nakajima ◽  
Kazuki Kano ◽  
Yukio Maezawa ◽  
Kousuke Ikeda ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Internal Hernia ◽  
Gastric Tube ◽  
Abdominal Cavity ◽  
Feeding Tube ◽  
Gastric Conduit ◽  
Round Ligament ◽  
Insertion Point ◽  
Tube Insertion ◽  
Gastric Tube Reconstruction

210 Background: We always used early enteral feeding after esophagectomy as perioperative management. The common procedure for feeding tube insertion is jejunostomy, but sometimes complication such as internal hernia was occurred. In case of retrosternal gastric tube reconstruction, we usually inserted feeding tube through gastric conduit. But in case of posterior mediastinal gastric tube reconstruction, this procedure was not available because of the distance between abdominal wall and gastric tube. So we have developed the new procedure for feeding tube insertion using the mobilized round ligament of liver. Methods: The aims of the study is to clarify the safety of these procedures. In case of retrosternal reconstruction, we usually inserted feeding tube from prepylorus of gastric conduit, and feeding tube was delivered through pyloric ring to 3rd portion of duodenum(Procedure A). Insertion point of the tube was always close to abdominal wall, and easy to be guided to extra-abdomen. On the other hand, in case of posterior reconstruction, we used the new procedure as below(Procedure B). At first, the round ligament of liver was cut at the liver edge. Next, feeding tube was inserted 15~20cm from anterior wall of 2nd portion of duodenum with Witzel suture fixation. After that, feeding tube was led to outside of the abdominal wall through in the mobilized round ligament. The cut edge of round ligament was fixed to the duodenum wall with 4-point suture at tube insertion point, and finally feeding tube completely surrounded by round ligament without direct exposure to the abdominal cavity. And to prevent internal hernia, the space between abdominal wall and mobilized round ligament was covered by omental fat. Results: From January 2012 to December 2014, 126 cases were inserted by procedure A, and from June 2015 to February 2016, 35 cases were done by procedure B. There was no trouble derived from the feeding tube insertion such as intra-operative bleeding, leakage of digestive juice, infectious complication, ileus, and there was no trouble in removal at outpatients in both procedures. Conclusions: Both procedures were safe, so we can manage the feeding tube insertion route by the reconstruction route after esophagectomy.

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