Reining in nasogastric tubes: Implementation of a pediatric bridle program

2021 ◽  
Vol 61 ◽  
pp. 1-6
Author(s):  
Julie Lavoie ◽  
Amber Smith ◽  
Ashley Stelter ◽  
Michael Uhing ◽  
Krista Blom ◽  
...  
Keyword(s):  

Anaesthesia ◽  
2001 ◽  
Vol 56 (11) ◽  
pp. 1116-1130 ◽  
Author(s):  
N. A. White
Keyword(s):  


2021 ◽  
Vol 16 (1) ◽  
Author(s):  
M. Marro ◽  
S. De Smet ◽  
D. Caldari ◽  
C. Lambe ◽  
S. Leclerc-Mercier ◽  
...  

Abstract Introduction Severe epidermolysis bullosa simplex (EBS sev) is a rare genodermatosis characterized by congenital generalized blistering and mucosal involvement. Increased needs and decreased intake quickly lead to nutritional imbalance. Enteral nutrition support is proposed, but classical nasogastric tubes are not well tolerated in these patients and gastrostomy is preferred. Objective and methods To report the experience with EBS sev in neonatal units of French reference centers for gastrostomy. In this retrospective multicentric study, we included all patients with EBS sev who had gastrostomy placement before age 9 months during neonatal care hospitalization. Results Nine infants (5 males/4 females) with severe skin and mucosal involvement were included. A gastrostomy was decided, at an early age (mean 3.7 months, range 1.4 to 8 months) in infants with mean weight 4426 g (range 3500 to 6000 g). Techniques used were endoscopy with the pull technique for 5 infants and surgery under general anesthesia for 4. Main complications were local but resolved after treatment. All infants gained weight after gastrostomy. The mean withdrawal time (n = 7) for the gastrostomy was 35.8 months (range 10.5 months to 6.5 years). Seven children had persistent oral disorders. Conclusions Gastrostomy in infants with EBS sev can be necessary in neonatal intensive care units. Both surgical and endoscopic pull techniques seem efficient, with good tolerance.





1991 ◽  
Vol 101 (2) ◽  
pp. 219
Author(s):  
A. D. Hassard
Keyword(s):  


2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Maria José Solana García ◽  
Jesús López-Herce Cid ◽  
César Sánchez Sánchez

Gastroesophageal reflux (GER) is very common in children due to immaturity of the antireflux barrier. In critically ill patients there is also a high incidence due to a partial or complete loss of pressure of the lower esophageal sphincter though other factors, such as the use of nasogastric tubes, treatment with adrenergic agonists, bronchodilators, or opiates and mechanical ventilation, can further increase the risk of GER. Vomiting and regurgitation are the most common manifestations in infants and are considered pathological when they have repercussions on the nutritional status. In critically ill children, damage to the esophageal mucosa predisposes to digestive tract hemorrhage and nosocomial pneumonia secondary to repeated microaspiration. GER is mainly alkaline in children, as is also the case in critically ill pediatric patients. pH-metry combined with multichannel intraluminal impedance is therefore the technique of choice for diagnosis. The proton pump inhibitors are the drugs of choice for the treatment of GER because they have a greater effect, longer duration of action, and a good safety profile.



1985 ◽  
Vol 93 (3) ◽  
pp. 330-334 ◽  
Author(s):  
Michael Persico ◽  
Geoffrey A. Barker ◽  
David P. Mitchell

Septicemia is common in patients in the pediatric intensive care unit (ICU) who have nasotracheal tubes. Although it is frequently caused by middle ear effusion (MEE), pneumatic otoscopy is not routinely performed in these patients. To demonstrate the value of this procedure, 46 pediatric ICU patients with nasotracheal tubes were followed daily with pneumatic otoscopy for 11 to 98 days and compared with 25 controls without nasotracheal tubes, 12 of whom had nasogastric tubes. Myringotomy was performed whenever blood culture became positive. MEE was significantly more frequent in patients with nasotracheal tubes (87%) than in patients with controls (23%) and occurred first on the side of intubation. Blood bacteria were identical to middle ear pathogens in 80% of patients. Nasogastric tubes were not significant in causing MEE. The high incidence of MEE resulting from nasotracheal intubation indicates the importance of including pneumatic otoscopy in the daily examination of these high-risk patients.



2020 ◽  
Vol 34 ◽  
pp. S56-S57
Author(s):  
R. Mandalia ◽  
E. Poimenidi ◽  
J. Edwards ◽  
M. Charlton ◽  
S. Hanna-Jumma ◽  
...  




Author(s):  
Ali Mohammadpour ◽  
Mousa Sajadi ◽  
Somayyeh Maghami ◽  
Hossein Soltani

Objective: Increased gastric residual volume is a complication of enteral nutrition intolerance that leads to gastrointestinal complications such as nausea, vomiting, and aspiration pneumonia. The present study was conducted to determine the effect of gastric gas emptying on the residual gastric volume in mechanically-ventilated patients fed through nasogastric tubes.Methods: This randomized, single-blind, clinical trial was conducted on two groups of patients in the intensive care unit (ICU) of Kamyab Hospital of Mashhad. A total of 64 patients were randomly divided into a case and a control group. In the case group, the gastric gases accumulated through the nasogastric tube were emptied by applying palm pressure on the epigastric region. The control group did not undergo this intervention but received the routine care provided in the ward. Data were collected using a demographic questionnaire and a form containing records of the patients’ residual gastric volume and disease-related information. The residual gastric volume was measured and compared in the two groups before and after the intervention. Data were analyzed in SPSS-19 using the Chi-square test, the independent t-test, and the repeated measures ANOVA at the significance level of 5%.Results: The residual gastric volume did not differ significantly between the two groups before the intervention (p=0.14); after the intervention; however, a significant reduction was observed in the case group compared to the controls (p=0.007).Conclusion: Gastric gas emptying helps reduce the residual gastric volume in mechanically-ventilated patients fed through nasogastric tubes. Further studies are recommended to further ensure the benefits of this method.



2019 ◽  
Vol 20 ◽  
pp. 224-227 ◽  
Author(s):  
Toru Yamada ◽  
Yasuaki Motomura ◽  
Eiji Hiraoka ◽  
Aki Miyagaki ◽  
Juichi Sato


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