scholarly journals The Placement of Post-pyloric Feeding Tubes Using DRX-Revolution Mobile X-Ray System in an ICU. A Case Series

2016 ◽  
Vol 2 (3) ◽  
pp. 131-134
Author(s):  
Leonid Koyfman ◽  
Andrei Schwartz ◽  
Yair Benjamin ◽  
Alexander Smolikov ◽  
Moti Klein ◽  
...  
Keyword(s):  
Enteral Nutrition ◽  
Critically Ill ◽  
Enteral Feeding ◽  
Nasogastric Tube ◽  
Critically Ill Patients ◽  
Case Series ◽  
Feeding Tube ◽  
Nasogastric Feeding ◽  
X Ray ◽  
Feeding Tubes

Abstract Enteral nutrition is crucial for ensuring that critically ill patients have a proper intake of food, water, and medicine. Methods to ensure this requirement should be initiated as early as possible. The use of PPF has several advantages compared to the use of a nasogastric feeding tube. In the present paper, the cases of three critically ill patients with a nonfunctional gastrointestinal system on admission to ICU, are detailed. Enteral feeding through a nasogastric tube by prokinetic agent therapy had been unsuccessful. The bedside placement of a post-pyloric feeding tube by the DRX-Revolution X-ray system is described.

Evaluation of Delivery of Enteral Nutrition in Critically Ill Patients Receiving Mechanical Ventilation

2008 ◽  
Vol 17 (1) ◽  
pp. 53-61 ◽  
Author(s):  
Debra O’Meara ◽  
Eduardo Mireles-Cabodevila ◽  
Fran Frame ◽  
A. Christine Hummell ◽  
Jeffrey Hammel ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Enteral Nutrition ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Feeding Tube ◽  
Feeding Tubes ◽  
Academic Center ◽  
Specific Step ◽  
Feeding Process ◽  
Medical Intensive Care

Background Published reports consistently describe incomplete delivery of prescribed enteral nutrition. Which specific step in the process delays or interferes with the administration of a full dose of nutrients is unclear. Objectives To assess factors associated with interruptions in enteral nutrition in critically ill patients receiving mechanical ventilation. Methods An observational prospective study of 59 consecutive patients who required mechanical ventilation and were receiving enteral nutrition was done in an 18-bed medical intensive care unit of an academic center. Data were collected prospectively on standardized forms. Steps involved in the feeding process from admission to discharge were recorded, each step was timed, and delivery of nutrition was quantified. Results Patients received approximately 50% (mean, 1106.3; SD, 885.9 Cal) of the prescribed caloric needs. Enteral nutrition was interrupted 27.3% of the available time. A mean of 1.13 interruptions occurred per patient per day; enteral nutrition was interrupted a mean of 6 (SD, 0.9) hours per patient each day. Prolonged interruptions were mainly associated with problems related to small-bore feeding tubes (25.5%), increased residual volumes (13.3%), weaning (11.7%), and other reasons (22.8%). Placement and confirmation of placement of the small-bore feeding tube were significant causes of incomplete delivery of nutrients on the day of admission. Conclusions Delivery of enteral nutrition in critically ill patients receiving mechanical ventilation is interrupted by practices embedded in the care of these patients. Evaluation of the process reveals areas to improve the delivery of enteral nutrition.

scholarly journals Comparison of Feeding Efficiency and Hospital Mortality between Small Bowel and Nasogastric Tube Feeding in Critically Ill Patients at High Nutritional Risk

Nutrients ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 2009
Author(s):  
Wei-Ning Wang ◽  
Chen-Yu Wang ◽  
Chiann-Yi Hsu ◽  
Pin-Kuei Fu
Keyword(s):  
Small Bowel ◽  
Enteral Nutrition ◽  
Hospital Mortality ◽  
Critically Ill ◽  
Energy Intake ◽  
Nasogastric Tube ◽  
Critically Ill Patients ◽  
Nutritional Risk ◽  
Nutrition Risk ◽  
Achievement Rate

Nasogastric tube enteral nutrition (NGEN) should be initiated within 48 h for patients at high nutritional risk. However, whether small bowel enteral nutrition (SBEN) should be routinely used instead of NGEN to improve hospital mortality remains unclear. We retrospectively analyzed 113 critically ill patients with modified Nutrition Risk in Critically Ill (mNUTRIC) score ≥ 5 and feeding volume < 750 mL/day in the first week of their stay in the intensive care unit (ICU). Age, sex, mNUTRIC score, and Acute Physiology and Chronic Health Evaluation II (APACHE II) score were matched in the SBEN (n = 48) and NGEN (n = 65) groups. Through a univariate analysis, factors associated with hospital mortality were SBEN group (hazard ratio (HR), 0.56; 95% confidence interval (CI), 0.31–1.00), Simplified Organ Failure Assessment (SOFA) score on day 7 (HR, 1.12; 95% CI, 1.03–1.22), and energy intake achievement rate < 65% (HR, 2.53; 95% CI, 1.25–5.11). A multivariate analysis indicated that energy intake achievement rate < 65% on the third follow-up day (HR, 2.29; 95% CI, 1.12–4.69) was the only factor independently associated with mortality. We suggest initiation of SBEN on the seventh ICU day before parenteral nutrition initiation for critically ill patients at high nutrition risk.

scholarly journals A Novel Technique for Post-pyloric Feeding Tube Placement in Critically Ill Patients: A Pilot Study

2005 ◽  
Vol 33 (2) ◽  
pp. 229-234 ◽  
Author(s):  
R. J. Young ◽  
M. J. Chapman ◽  
R. Fraser ◽  
R. Vozzo ◽  
D. P. Chorley ◽  
...  
Keyword(s):  
Gastric Emptying ◽  
Pilot Study ◽  
Real Time ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Feeding Tube ◽  
Insertion Time ◽  
Tube Placement ◽  
Feeding Tubes ◽  
Feeding Tube Placement

Delivery of enteral nutrition in critically ill patients is often hampered by gastric stasis necessitating direct feeding into the small intestine. Current techniques for placement of post-pyloric feeding catheters are complex, time consuming or both, and improvements in feeding tube placement techniques are required. The Cathlocator™ is a novel device that permits real time localisation of the end of feeding tubes via detection of a magnetic field generated by a small electric current in a coil incorporated in the tip of the tube. We performed a pilot study evaluating the feasibility of the Cathlocator™ system to guide and evaluate the placement of (1) nasoduodenal feeding tubes, and (2) nasogastric drainage tubes in critically ill patients with feed intolerance due to slow gastric emptying. A prospective study of eight critically ill patients was undertaken in the intensive care unit of a tertiary hospital. The Cathlocator™ was used to (1) guide the positioning of the tubes post-pylorically and (2) determine whether nasogastric and nasoduodenal tubes were placed correctly. Tube tip position was compared with data obtained by radiology. Data are expressed as median (range). Duodenal tube placement was successful in 7 of 8 patients (insertion time 12.6 min (5.3–34.4)). All nasogastric tube placements were successful (insertion time 3.4 min (0.6–10.0)). The Cathlocator™ accurately determined the position of both tubes without complication in all cases. The Cathlocator™ allows placement and location of an enteral feeding tube in real time in critically ill patients with slow gastric emptying. These findings warrant further studies into the application of this technique for placement of post-pyloric feeding tubes.

Long-term Enteral Access in Aspiration-prone Patients

1995 ◽  
Vol 10 (4) ◽  
pp. 179-186 ◽  
Author(s):  
Alex C. Cech ◽  
Jon B. Morris ◽  
James L. Mullen ◽  
Gary W. Crooks
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Enteral Nutrition ◽  
Critically Ill ◽  
Enteral Feeding ◽  
Critically Ill Patients ◽  
Nutrition Support ◽  
Enteral Access ◽  
Enteral Nutrition Support

Aspiration pneumonia is a serious complication of enteral feeding. Many critically ill patients are particularly at risk for aspiration. Few studies have rigorously compared various access devices. Risk factors for aspiration and studies examining aspiration associated with enteral feeding devices are reviewed. We recommend a surgical jejunostomy for all patients at high risk for aspiration who require more than 3 weeks of enteral nutrition support.

Fatal Complications of Nasogastric Tube Misplacement in Two Dogs

2021 ◽  
Author(s):  
Jenniffer Rodriguez-Diaz ◽  
Julia P. Sumner ◽  
Meredith Miller
Keyword(s):  
Risk Factors ◽  
Case Report ◽  
Enteral Nutrition ◽  
Case Reports ◽  
Case Series ◽  
Feeding Tube ◽  
Tracheobronchial Tree ◽  
Human Medicine ◽  
Feeding Tubes ◽  
Fatal Complications

ABSTRACT Provision of enteral nutrition via the use of nasoenteric feeding tubes is a commonly used method in both veterinary and human medicine. Although case reports in human medicine have identified fatalities due to misplacement of nasogastric (NG) tubes into the tracheobronchial tree and subsequent pneumothorax, there are no case reports, to our knowledge, of fatalities in veterinary patients. This case report describes two fatalities caused by misplaced NG tubes in intubated patients (one intraoperative, one postoperative). This report highlights risk factors for feeding tube complications and methods to prevent future fatalities such as two-view radiography, two-step insertion, capnography, laryngoscopic-assisted placement, and palpation of the NG tube in the stomach. The recent fatalities discussed within this case series demonstrate that deaths as a result of NG tubes misplaced into the tracheobronchial tree occur in veterinary patients, and measures should be taken to prevent this complication.

scholarly journals Impact of Intravenous Fluids and Enteral Nutrition on the Severity of Gastrointestinal Dysfunction: A Systematic Review and Meta-analysis

2020 ◽  
Vol 6 (1) ◽  
pp. 5-24
Author(s):  
Varsha M. Asrani ◽  
Annabelle Brown ◽  
Ian Bissett ◽  
John A. Windsor
Keyword(s):  
Enteral Nutrition ◽  
Anastomotic Leak ◽  
Critically Ill ◽  
Fluid Resuscitation ◽  
Enteral Feeding ◽  
Critically Ill Patients ◽  
Intravenous Fluid ◽  
Intravenous Fluids ◽  
Gastrointestinal Dysfunction ◽  
The Impact

AbstractIntroductionGastrointestinal dysfunction (GDF) is one of the primary causes of morbidity and mortality in critically ill patients. Intensive care interventions, such as intravenous fluids and enteral feeding, can exacerbate GDF. There exists a paucity of high-quality literature on the interaction between these two modalities (intravenous fluids and enteral feeding) as a combined therapy on its impact on GDF.AimTo review the impact of intravenous fluids and enteral nutrition individually on determinants of gut function and implications in clinical practice.MethodsRandomized controlled trials on intravenous fluids and enteral feeding on GDF were identified by a comprehensive database search of MEDLINE and EMBASE. Extraction of data was conducted for study characteristics, provision of fluids or feeding in both groups and quality of studies was assessed using the Cochrane criteria. A random-effects model was applied to estimate the impact of these interventions across the spectrum of GDF severity.ResultsRestricted/ goal-directed intravenous fluid therapy is likely to reduce ‘mild’ GDF such as vomiting (p = 0.03) compared to a standard/ liberal intravenous fluid regime. Enterally fed patients experienced increased episodes of vomiting (p = <0.01) but were less likely to develop an anastomotic leak (p = 0.03) and peritonitis (p = 0.03) compared to parenterally fed patients. Vomiting (p = <0.01) and anastomotic leak (p = 0.04) were significantly lower in the early enteral feeding group.ConclusionsThere is less emphasis on the combined approach of intravenous fluid resuscitation and enteral feeding in critically ill patients. Conservative fluid resuscitation and aggressive enteral feeding are presumably key factors contributing to severe life-threatening GDF. Future trials should evaluate the impact of cross-interaction between conservative and aggressive modes of these two interventions on the severity of GDF.

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