BibTex RIS Cite

Department of Anesthesiology and Reanimation, School of Medicine, Marmara University, Istanbul, Turkey

Year 2002, Volume: 15 Issue: 4, 239 - 243, 03.12.2016

Abstract

Objective: The aim of this prospective and randomized study was to compare the methods used for the assessment of the nasoduodenal tube position in critically ill patients according to the success rate, time spent on successful placement and cost effectivity.
Methods: Sixty critically ill patients for whom enteral feeding with nasoduodenal tube (ND) was planned, were allocated randomly into 3 groups. The assessment of the location of the ND tube was done by auscultation of the loudest sound location over the right flank in group A, pH determination of the duodenal aspirate in group PH and fluoroscopic view in group F. The failure criteria was the placement of a ND tube in the stomach in all groups, the necessity of having more than two flat abdominal radiographs in group A and PH, the duration of fluoroscopy for more than 10 minutes in group F. The success rate, the time of successful placement and the total cost were determined and compared statistically by using analysis of variance and Fisher’s Exact Test.
Results: The success rate was significantly higher in group F (95%). The time of successful placement was significantly shorter in group F (75.15 ± 5.32 min versus 147.95 ± 77.05 min in group A and 177.75 ± 154.84 min in group PH).
There was no difference between groups regarding the total cost. A 25% false positive result was found in the PH group i.e. the tube was found to be in the stomach after the radiological evaluation although pH values were > 4.
Conclusion: For critically ill patients in whom enteral feeding is planned with ND, fluoroscopy should be preferred whenever possible for the placement of the ND tube because the success rate is higher, the placement is quicker and it is more cost-effective than the conventional methods.
Key Words: Enteral nutrition, Enteral tube insertion, Fluoroscopy.

References

  • Heyland DK, Drover JW, MacDonald S, et at. Effect of postpyloric feeding on gastroesophageal regurgitation and pulmonary microaspiration: Results of a randomized controlled trial. Crit Care Med 2001;29:1495-1501.
  • Bengmark S. Progress in perioperative enteral tube feeding. Clin Hutr 1998; !7: 145-152.
  • Zaloga GP. Bedside method for placing small bowel feeding tubes in critically ill patients: A prospective study. Chest 1991; 100:1643- 1646.
  • Heiselman DE, Vidovich RR, Mildovich G, et al. riasolntestinal tube placement with a ph sensor feeding tube. JPEbi 1993; 17: 562- 565.
  • Rujeles S, Gomez G, Cadena E, et al. Sondas de alimentación enteral: Validación de una técnica sencilla de intubación transpilorica. Universitas Medica 1993; 34: 19-23.
  • Grant JP, Curtas MS, Kelvin EM. Radiologic placement of nasojejunal feeding tubes with immediate feedings using a nonelemental diet. JPEbi 1993; 7:299-303.
  • Prager R, Laboy V, Venus B. Value of radiologic asistance during transpyloric intubation. Crit Care Med 1986; 14: 151-152.
  • Pearce CB, Duncan HD. Enteral feeding, blasogastric, nasojejunal, percutaneous
  • endoscopic gastrostomy or jejunostomy: Its indications and limitations. Postgrad Med J 2002; 78: 198-204.
  • Marik PE, Lorenza A. Effect of tube
  • feedings on the measurement of gastric intramucosal pH. Crit Care Med 1996; 24: 1498-1500.
  • Welch SK, Hanlon MD, Waits M, et al. Comparison of four bedside indicators used to predict duodenal feeding tube placement with radiography. JPEbi 1994; 18: 525-530.
  • I I. bieumann MJ, Meyer CT, Dutton JL, et al. Hold that x-ray: aspirate pH and auscultation prove enteral placement. J Clin Gastroenterol 1995; 20: 293-295.
  • Metheny HA, Spies M, Eisenberg P. Frequency of nasoenteral tube displacement and associated risk factors. Res biurs Health 1986; 9: 241-247.
  • Metheny HA, Smith L, Steward BJ. Development of a reliable and valid bedside test for bilirubin and its utility for improving prediction of feeding tube location, blurs Res 2000; 49: 302-309.
  • Metheny HA, Steward BJ, Smith L, et al. pH and concentrations of pepsin and tripsin in feeding tube aspirates as predictors of tube placement. JPEbi 1997; 21: 279-285.
  • Hillard AE, Waddell JJ, Metzler AIff et al. Fluoroscopically guided nasoenteric feeding tube placement versus bedside placement. South Med J 1995; 88: 425-428.
  • Gutierrez ED, Balfe DM. Fluoroscopically guided nasoenteric feeding tube placement: results of a I-year study. Radiology 1991; I 78: 759-762.
  • I 7. Huerta G, Puri VK. btasoenteric feeding tubes in critically ill patients (fluoroscopy versus blind), nutrition 2000; 16: 264-267.
  • Kwauk ST, Miles D, Pinilla J, et al. A simple method for endoscopic placement of a nasoduodenal feeding tube. Surg Endosc 1996; 10: 680-683.
  • Patrick PG, Marulendra S, Kirby DF, et al. Endoscopic nasogastric-jejunal feeding tube placement in critically ill patients. Gastrointest Endosc 1997; 45: 72-76.
  • Kearns PJ. A controlled comparison of traditional feeding tube verification methods to a bedside, electromagnetic technique. JPEbi 2001; 25: 210-205.
Year 2002, Volume: 15 Issue: 4, 239 - 243, 03.12.2016

Abstract

References

  • Heyland DK, Drover JW, MacDonald S, et at. Effect of postpyloric feeding on gastroesophageal regurgitation and pulmonary microaspiration: Results of a randomized controlled trial. Crit Care Med 2001;29:1495-1501.
  • Bengmark S. Progress in perioperative enteral tube feeding. Clin Hutr 1998; !7: 145-152.
  • Zaloga GP. Bedside method for placing small bowel feeding tubes in critically ill patients: A prospective study. Chest 1991; 100:1643- 1646.
  • Heiselman DE, Vidovich RR, Mildovich G, et al. riasolntestinal tube placement with a ph sensor feeding tube. JPEbi 1993; 17: 562- 565.
  • Rujeles S, Gomez G, Cadena E, et al. Sondas de alimentación enteral: Validación de una técnica sencilla de intubación transpilorica. Universitas Medica 1993; 34: 19-23.
  • Grant JP, Curtas MS, Kelvin EM. Radiologic placement of nasojejunal feeding tubes with immediate feedings using a nonelemental diet. JPEbi 1993; 7:299-303.
  • Prager R, Laboy V, Venus B. Value of radiologic asistance during transpyloric intubation. Crit Care Med 1986; 14: 151-152.
  • Pearce CB, Duncan HD. Enteral feeding, blasogastric, nasojejunal, percutaneous
  • endoscopic gastrostomy or jejunostomy: Its indications and limitations. Postgrad Med J 2002; 78: 198-204.
  • Marik PE, Lorenza A. Effect of tube
  • feedings on the measurement of gastric intramucosal pH. Crit Care Med 1996; 24: 1498-1500.
  • Welch SK, Hanlon MD, Waits M, et al. Comparison of four bedside indicators used to predict duodenal feeding tube placement with radiography. JPEbi 1994; 18: 525-530.
  • I I. bieumann MJ, Meyer CT, Dutton JL, et al. Hold that x-ray: aspirate pH and auscultation prove enteral placement. J Clin Gastroenterol 1995; 20: 293-295.
  • Metheny HA, Spies M, Eisenberg P. Frequency of nasoenteral tube displacement and associated risk factors. Res biurs Health 1986; 9: 241-247.
  • Metheny HA, Smith L, Steward BJ. Development of a reliable and valid bedside test for bilirubin and its utility for improving prediction of feeding tube location, blurs Res 2000; 49: 302-309.
  • Metheny HA, Steward BJ, Smith L, et al. pH and concentrations of pepsin and tripsin in feeding tube aspirates as predictors of tube placement. JPEbi 1997; 21: 279-285.
  • Hillard AE, Waddell JJ, Metzler AIff et al. Fluoroscopically guided nasoenteric feeding tube placement versus bedside placement. South Med J 1995; 88: 425-428.
  • Gutierrez ED, Balfe DM. Fluoroscopically guided nasoenteric feeding tube placement: results of a I-year study. Radiology 1991; I 78: 759-762.
  • I 7. Huerta G, Puri VK. btasoenteric feeding tubes in critically ill patients (fluoroscopy versus blind), nutrition 2000; 16: 264-267.
  • Kwauk ST, Miles D, Pinilla J, et al. A simple method for endoscopic placement of a nasoduodenal feeding tube. Surg Endosc 1996; 10: 680-683.
  • Patrick PG, Marulendra S, Kirby DF, et al. Endoscopic nasogastric-jejunal feeding tube placement in critically ill patients. Gastrointest Endosc 1997; 45: 72-76.
  • Kearns PJ. A controlled comparison of traditional feeding tube verification methods to a bedside, electromagnetic technique. JPEbi 2001; 25: 210-205.
There are 22 citations in total.

Details

Journal Section Original Research
Authors

Tümay Umuroğlu This is me

Zeynep Eti This is me

Arzu Takıl This is me

Yılmaz Göğüş This is me

Publication Date December 3, 2016
Published in Issue Year 2002 Volume: 15 Issue: 4

Cite

APA Umuroğlu, T., Eti, Z., Takıl, A., Göğüş, Y. (2016). Department of Anesthesiology and Reanimation, School of Medicine, Marmara University, Istanbul, Turkey. Marmara Medical Journal, 15(4), 239-243.
AMA Umuroğlu T, Eti Z, Takıl A, Göğüş Y. Department of Anesthesiology and Reanimation, School of Medicine, Marmara University, Istanbul, Turkey. Marmara Med J. March 2016;15(4):239-243.
Chicago Umuroğlu, Tümay, Zeynep Eti, Arzu Takıl, and Yılmaz Göğüş. “Department of Anesthesiology and Reanimation, School of Medicine, Marmara University, Istanbul, Turkey”. Marmara Medical Journal 15, no. 4 (March 2016): 239-43.
EndNote Umuroğlu T, Eti Z, Takıl A, Göğüş Y (March 1, 2016) Department of Anesthesiology and Reanimation, School of Medicine, Marmara University, Istanbul, Turkey. Marmara Medical Journal 15 4 239–243.
IEEE T. Umuroğlu, Z. Eti, A. Takıl, and Y. Göğüş, “Department of Anesthesiology and Reanimation, School of Medicine, Marmara University, Istanbul, Turkey”, Marmara Med J, vol. 15, no. 4, pp. 239–243, 2016.
ISNAD Umuroğlu, Tümay et al. “Department of Anesthesiology and Reanimation, School of Medicine, Marmara University, Istanbul, Turkey”. Marmara Medical Journal 15/4 (March 2016), 239-243.
JAMA Umuroğlu T, Eti Z, Takıl A, Göğüş Y. Department of Anesthesiology and Reanimation, School of Medicine, Marmara University, Istanbul, Turkey. Marmara Med J. 2016;15:239–243.
MLA Umuroğlu, Tümay et al. “Department of Anesthesiology and Reanimation, School of Medicine, Marmara University, Istanbul, Turkey”. Marmara Medical Journal, vol. 15, no. 4, 2016, pp. 239-43.
Vancouver Umuroğlu T, Eti Z, Takıl A, Göğüş Y. Department of Anesthesiology and Reanimation, School of Medicine, Marmara University, Istanbul, Turkey. Marmara Med J. 2016;15(4):239-43.