Placement of a nasoenteric feeding tube beyond the pylorus in critically ill patients is desirable.
Bedside methods are unreliable, and fluoroscopic methods require transport and/or radiation exposure.
Traditional endoscopic methods require sedation and oronasal transfer techniques.
Transnasal techniques of nasoenteric feeding tube placement by using recently developed ultrathin endoscopes have been described.
Dr John Fang and colleagues from Utah compared the efficacy of nasoenteric feeding tube placement.
The research team compared ultrathin transnasal endoscopy vs fluoroscopic placement.
The researchers conducted a prospective randomized study of endoscopic vs fluoroscopic nasoenteric feeding tube placement at an academic medical center.
The research team included 100 consecutive patients who required nasoenteric feeding tube placement.
|Jejunal placement increased to 100% with the last 10 endoscopic procedures|
The team received endoscopic nasoenteric feeding tube placement at the bedside with a 5-mm, ultrathin endoscope.
The researchers used a transnasal over-the-wire technique vs fluoroscopic nasoenteric feeding tube placement by applying standard techniques.
The procedure success was defined as postpyloric nasoenteric feeding tube placement, jejunal placement success, and procedure time.
Tube placement success was not significantly different between endoscopic and fluoroscopic methods.
The researchers found that the endoscopic procedure duration was significantly shorter than fluoroscopic procedure duration.
Procedure duration decreased significantly from 17 minutes to 8 minutes.
The team noted that jejunal placement increased significantly from 60% to 100% from the first to the last 10 endoscopic procedures.
Dr Fang's team commented, “Nasoenteric feeding tube placement success with an ultrathin transnasal endoscope is equivalent to fluoroscopic placement with faster procedure times.”
“More distal placement and procedure times improve with increasing experience with the endoscopic technique.”
“Endoscopic nasoenteric feeding tube placement can be performed at the bedside without the need for oronasal transfer, additional sedation, or fluoroscopy.”