Endoscopically Assisted Nasojejunal Feeding Tube Placement: Technique and Results in Five Dogs

Interest in noninvasive feeding tube placement in companion animals led to the adaption of a human technique utilizing endoscopy to place nasojejunal feeding tubes. Data from medical records in which nasojejunal feeding tubes were attempted were reviewed. Feeding tubes were attempted and successfully placed in five dogs within a median of 35 min. Feeding tubes remained in place for approximately 7 days. Complications included facial irritation (5/5), sneezing (5/5), fractured facial sutures (4/5), vomiting (3/5), diarrhea (3/5), crimping of feeding tube (3/5), regurgitation (1/5), epistaxis (1/5), clogging of the feeding tube (2/5), and oral migration with premature removal of the feeding tube (1/5). The deployment technique used in this study was found to be cumbersome. Despite minor complications, endoscopy can be used to rapidly and accurately place nasoenteric feeding devices.

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Rapid Placement of Transpyloric Feeding Tubes: A Comparison of pH-assisted and Standard Insertion Techniques in Children

PEDIATRICS ◽

10.1542/peds.98.2.242 ◽

1996 ◽

Vol 98 (2) ◽

pp. 242-248

Author(s):

Brian Krafte-Jacobs ◽

Melody Persinger ◽

Jeannean Carver ◽

Lori Moore ◽

Richard Brilli

Keyword(s):

Hospital Costs ◽

Caloric Intake ◽

Feeding Tube ◽

Cost Comparison ◽

Tube Placement ◽

Critically Ill Children ◽

Standard Group ◽

Feeding Tubes ◽

Feeding Tube Placement ◽

Placement Technique

Objective. To compare transpyloric feeding tube placement using a pH-assisted placement technique versus a standard placement technique in pediatric patients requiring enteral nutrition. Methods. Critically ill children younger than 4 years were prospectively and randomly assigned to either a pH-assisted or a standard feeding tube placement group. Identical pH-assisted feeding tubes were used in both groups; however, feeding tubes in the standard group were not attached to a portable pH meter. Successful transpyloric placement was confirmed by radiography before beginning feedings. If placement was not successful, a second placement attempt was made after metoclopramide administration. Information regarding tube placement success, number of radiographs, time to initiaction of feedings, and daily caloric intake was collected. A cost comparison between the two groups was performed. Results. Thirty-four patients were enrolled in the pH-assisted group, and 34 were enrolled in the standard feeding tube group. Ninety-seven percent of patients in the pH-assisted group had successful placement after the first attempt, compared with 53% of patients in the standard group. The average time to successful placement of pH-assisted feeding tubes was 6 minutes. All patients in the pH-assisted group had successful placement after the second attempt, compared with 78% of patients in the standard group. A pH of greater than 5.6 accurately predicted transpyloric placement in 97% (33 of 34) of individuals in the pH-assisted group. Children in the pH-assisted group required significantly fewer radiographs than those in the standard group. Hospital costs were $114 per patient in the pH-assisted group and $135 per patient in the standard group. Conclusions. Our findings indicate that bedside transpyloric placement of pH-assisted feeding tubes can be accomplished rapidly and with a high success rate. This method is associated with decreased radiation exposure and economic savings when compared with a standard placement technique.

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Su1567 Nasojejunal Feeding Tube Placement Technique Utilizing Through-the-Scope Advancement: a Simple Technique Maximizing Distal Placement

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2015.03.1464 ◽

2015 ◽

Vol 81 (5) ◽

pp. AB332-AB333

Author(s):

Karin S. Gilkison ◽

James M. Francis ◽

Daniel Brady ◽

Jeffery Wolff

Keyword(s):

Simple Technique ◽

Feeding Tube ◽

Tube Placement ◽

Nasojejunal Feeding ◽

Feeding Tube Placement ◽

Placement Technique

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

Gastroenterology Research and Practice ◽

10.1155/2018/1671483 ◽

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.

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

Anaesthesia and Intensive Care ◽

10.1177/0310057x0503300212 ◽

2005 ◽

Vol 33 (2) ◽

pp. 229-234 ◽

Cited By ~ 15

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.

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