Rhubarb to Facilitate Placement of Nasojejunal Feeding Tubes in Patients in the Intensive Care Unit

Background: safe placement and securement of feeding tubes are essential to establishing early enteral nutrition. Nasogastric or nasojejunal feeding tubes are often inadvertently removed, and using a nasal bridle can reduce the number of tube replacements required. Aim: to review current nasal bridle practices on one intensive care unit. Over a 3-month period, nasal bridle use was recorded to measure unintentional tube loss and tube duration (the time a tube remained in situ). Method: an observational service evaluation. Findings: 109 patients were recruited; 205 tubes were passed and 77 bridles were inserted, with 42% (n=46) of the bridles placed on day 1. Tubes secured with tape were more likely to be dislodged than tubes secured with a bridle, P=0.0001. Duration of tubes remaining in situ was significantly longer in patients who had a bridle fitted on day 1, P=0.0001 compared with tubes secured with tape. Conclusion: securing a tube with a nasal bridle from day 1 is independently associated with reduced tube loss, increased duration of tube use, and likelihood that the tube would reach redundancy when it was no longer required.

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Guided Placement of Nasojejunal Feeding Tubes Using Erythromycin and Fluoroscopy in Intensive Care Unit Patients

Problems of the Gastrointestinal Tract in Anesthesia, the Perioperative Period, and Intensive Care ◽

10.1007/978-3-642-60200-9_9 ◽

1999 ◽

pp. 79-82

Author(s):

J. Barnert ◽

G. Neeser ◽

M. Wienbeck

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Feeding Tubes ◽

Nasojejunal Feeding

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Enteral feeding tubes in the intensive care unit: efficiency of placement and morbidities associated with use

Current Surgery ◽

10.1016/s0149-7944(00)00336-6 ◽

2000 ◽

Vol 57 (5) ◽

pp. 502-503

Author(s):

W Arnold ◽

P Mohen ◽

S Nasraway

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Enteral Feeding ◽

Feeding Tubes

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Use of a Nutrition Support Protocol to Increase Enteral Nutrition Delivery in Critically Ill Patients

American Journal of Critical Care ◽

10.4037/ajcc2014140 ◽

2014 ◽

Vol 23 (5) ◽

pp. 396-403 ◽

Cited By ~ 16

Author(s):

Friederike Compton ◽

Christian Bojarski ◽

Britta Siegmund ◽

Markus van der Giet

Keyword(s):

Intensive Care Unit ◽

Mechanical Ventilation ◽

Intensive Care ◽

Enteral Nutrition ◽

Invasive Mechanical Ventilation ◽

Nutrition Support ◽

Early Enteral Nutrition ◽

Feeding Tubes ◽

Enteral Nutrition Support ◽

The Impact

BackgroundEarly enteral nutrition is recommended for patients in intensive care units, but nutrition provision is often hindered by a variety of unit-specific problems.ObjectivesTo evaluate the impact of a nutrition support protocol on nutrition prescription and delivery in the intensive care unit.MethodsNutrition-related data from 73 patients receiving mechanical ventilation who were treated in an adult medical intensive care unit before introduction of an enteral nutrition support protocol were retrospectively compared with data for 87 patients admitted after implementation of the protocol.ResultsAfter implementation of the protocol, enteral nutrition was started significantly earlier (P = .007) and enteral feeding goals were reached significantly faster (6 vs 10 days, P < .001) than before. Prescription of enteral nutrition on the first day of invasive mechanical ventilation increased from 38% before to 54% after (P = .03) implementation of the protocol. Prescribed and delivered nutrition doses on the first 2 days of mechanical ventilation also increased significantly (P < .001) after the protocol was implemented. Nasojejunal feeding tubes were used in 52% of patients before and 56% of patients after protocol implementation P = .63). Jejunal tubes were placed earlier after the protocol was implemented than before (median 5 vs 6.5 days), and when a jejunal tube was in place, feeding goals were reached faster (median 2 vs 3 days, P = .002).ConclusionImplementing an enteral nutrition support protocol shortened the time to reach feeding goals. Jejunal feeding tubes were necessary in more than half of the patients, and with a jejunal feeding tube in place, feeding goals were reached rapidly.

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Bedside placement of transpyloric feeding tubes in the pediatric intensive care unit using gastric insufflation

Critical Care Medicine ◽

10.1097/00003246-200006000-00060 ◽

2000 ◽

Vol 28 (6) ◽

pp. 2041-2044 ◽

Cited By ~ 35

Author(s):

H. Kenneth Spalding ◽

Kevin J. Sullivan ◽

Oludapo Soremi ◽

Floyd Gonzalez ◽

Salvatore R. Goodwin

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Pediatric Intensive Care Unit ◽

Pediatric Intensive Care ◽

Feeding Tubes ◽

Gastric Insufflation

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Off-label use of drugs administered by enteral feeding tubes in an Intensive Care Unit in Fortaleza, Brazil

Revista Brasileira de Farmácia Hospitalar e Serviços de Saúde ◽

10.30968/rbfhss.2021.121.0562 ◽

2021 ◽

Vol 12 (1) ◽

pp. 562

Author(s):

Gabriela A. ABREU ◽

Elana F. CHAVES ◽

José A. NETO ◽

Lívia P. MOREIRA ◽

Johann V. SILVA ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Cardiovascular System ◽

Enteral Feeding ◽

University Hospital ◽

Adult Intensive Care Unit ◽

Feeding Tubes ◽

Oral Medications ◽

Oral Formulations ◽

Administration Methods

Objective: To analyze the prescription profile of drugs administered through enteral feeding tubes in an adult intensive care unit and gather recommendations for their safe administration. Methods: This is a descriptive and retrospective study conducted with adult critical clinical patients of a university hospital in Fortaleza-Ceará from March to May 2018. We performed analyses of patients’ medical records and prescriptions regarding drugs, pharmaceutical presentations and the possibility of administration through enteral tubes. Results: 489 prescriptions containing 1914 items were evaluated, from which 16.6% (n = 318) through tubes. Medicines for the cardiovascular system (34.6%), nervous system (27.4%) and digestive system and metabolism (15.1%) were the most predominant, with an average of 5.8 (DP: 4.2) different per patient. Regarding the pharmaceutical presentation, oral solids were frequently prescribed via enteral tube (67.9%), especially risperidone (8.8%), carvedilol (8.3%) and amiodarone (7.9%). There were contraindications for administration through tubes in 21.6% of solid oral formulations, while there were alternative standardized pharmaceutical forms in the hospital for 43.1%. In addition, substitution for liquid preparations from the market were possible in 43.1%. Among those to which there were no alternative formulations, drugs targeting the cardiovascular system prevailed (52.2%). A table with guidelines for the proper administration of the prescribed solid medications was elaborated then. Conclusion: Solid oral medications were frequently prescribed through enteral tubes, especially those for the cardiovascular system without alternative formulations, which shows the need for guidelines to promote the safety of this process.

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