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Updated: Aug 11, 2026
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Published on: January 17, 2011
Bedside placement of transpyloric feeding tubes in the pediatric intensive care unit using gastric insufflation
H K Spalding1, K J Sullivan, O Soremi
1Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida, USA.
Insights
Gastric insufflation significantly improves nasoenteral feeding tube placement in children, reducing attempts and time to feeding. This method enhances patient care by enabling faster nutritional support.
Area of Science:
- Pediatric critical care medicine
- Gastroenterology
- Medical device technology
Background:
- Accurate placement of nasoenteral feeding tubes is crucial for effective enteral nutrition in pediatric patients.
- Standard techniques for small bowel feeding tube insertion can be challenging and time-consuming.
- Gastric insufflation is a novel technique explored to facilitate tube navigation.
Purpose of the Study:
- To evaluate the efficacy of gastric insufflation as an adjunct for placing feeding tubes into the small bowel.
- To compare the success rate and time to placement using gastric insufflation versus a standard technique.
Main Methods:
- A prospective, randomized, controlled study was conducted in a pediatric intensive care unit.
- Fifty children requiring small bowel feeding tubes were randomized into two groups: gastric insufflation and control.
- The gastric insufflation group received air injection to aid tube advancement past the pylorus into the duodenum.
Main Results:
- Gastric insufflation led to successful first-attempt placement in 23/25 patients, compared to 11/25 in the control group (p = .001).
- All tubes were placed within two attempts in the gastric insufflation group versus 18/25 in the control group (p < .001).
- The time to initiate feeding was significantly shorter with gastric insufflation, with no reported complications.
Conclusions:
- Gastric insufflation is an effective method for rapid and successful placement of feeding tubes in the small bowel of children.
- This technique requires fewer attempts and reduces the overall time to feeding initiation compared to standard methods.
- Gastric insufflation offers a safe and efficient adjunct for nasoenteral feeding tube placement in pediatric critical care settings.
Objective:
To test the effectiveness of gastric insufflation as an adjunct to placement of feeding tubes in the small bowel.
Design:
Prospective, randomized, controlled study.
Setting:
Pediatric intensive care unit in a tertiary children's hospital.
Patients:
A total of 50 children requiring enteral nutrition via a nasoenteral feeding tube in the small bowel.
Interventions:
An unweighted nasoenteral feeding tube attached to a three-way stopcock and a 60 mL syringe was inserted through the nares into the stomach. After 10 mL/kg of air was injected, the tube was advanced a distance estimated to position the tip of the tube proximal to the pylorus. An additional 10 mL/kg of air was then injected, and the tube was advanced a distance needed to place the tube in the fourth part of the duodenum. In the control group, feeding tubes were inserted through the nares and into the stomach. The tube was then advanced a distance estimated to place the tube in the fourth part of the duodenum. No air was injected in the control group.
Measurements And Main Results:
When gastric insufflation was used, 23 of 25 feeding tubes were successfully placed in the small bowel on the first attempt compared with 11 of 25 in the control group (p = .001). All feeding tubes were successfully placed after two attempts in the gastric insufflation group compared with 18 of 25 in the control group (p < .001). The time between the first attempt at placement of a transpyloric feeding tube and the initiation of feeding was significantly shorter in the study group than in the control group. There were no complications in either group.
Conclusion:
Gastric insufflation allows rapid placement of feeding tubes into the small bowel with fewer attempts compared with a standard insertion technique in children.
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