Magnetically guided nasoenteral feeding tubes: a new technique

Our objective was to evaluate a new technique for the bedside placement of nasoenteral feeding tubes into the duodenum using an external hand-held magnet to maneuver the tube from the stomach to the distal duodenum. We conducted a prospective case series of 20 consecutive patients requiring nasoenteral tube feeding in the intensive care units of a university-affiliated hospital. Twenty patients were entered into the study after the attending physician requested assistance in tube placement. A flexible nasoenteral feeding tube (12 F), modified to include a magnet and a magnetic field sensor in the distal tip connected by a thin insulated wire to a small light at the proximal end, was passed per nares into the stomach. A larger hand-held magnet held over the epigastrium was used to magnetically "capture" the tube tip, indicated by the illumination of the proximal light. The tube tip was then maneuvered by the hand-held magnet along the lesser curvature of the stomach, through the pylorus, and into the duodenum. Procedure time and anatomic location of the tube tip as determined by an abdominal radiograph was recorded. The 12 men and eight women had a mean age of 60 years (range 30-84). The procedure time averaged 9.6 minutes (range 1-30). In 19 of the 20 patients (95%) radiographs revealed successful placement of the tip of the feeding tube into the duodenum. There were no complications related to the procedure. Using a novel magnetically guided nasoenteral feeding tube transpyloric tube placement was achieved in 95 per cent of cases with an average procedure time of 9.6 minutes. This new and inexpensive bedside technique will allow prompt and safe initiation of enteral nutrition.