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Retrospective Review of Current Nasojejunal Tube Insertion Practice

Natasha Sheikh1, Michelle Falkiner1, Mary-Louise Greer2

  • 1The Hospital for Sick Children, Toronto, Ontario, Canada.

Global Pediatric Health
|June 24, 2016
PubMed

Insights

Repeated fluoroscopically guided nasojejunal tube (NJT) insertions in children lead to significant radiation exposure, especially in infants. Strategies like bedside insertion may reduce risks associated with NJT reinsertions.

Area of Science:

  • Pediatric Gastroenterology
  • Medical Imaging
  • Radiation Safety

Background:

  • Fluoroscopically guided nasojejunal tube (NJT) insertions are common in pediatric care.
  • Repeated procedures increase cumulative radiation exposure, posing health risks, particularly for young children.

Purpose of the Study:

  • To analyze the frequency of NJT reinsertions in children.
  • To evaluate the associated radiation exposure (Dose Actual Percentage [DAP]) from these reinsertions.
  • To identify factors influencing NJT reinsertion rates and radiation dose.

Main Methods:

  • Retrospective analysis of 449 NJT insertions in 252 children (<18 years) from 2007-2012.
  • Data collected included patient demographics, reinsertion frequency, DAP, time intervals, and indications.
  • Statistical evaluation of reinsertion rates and radiation dose correlation with patient factors.

Main Results:

  • 41.7% of patients required NJT reinsertion, with 5.6% needing five or more.
  • 67.6% of reinsertions occurred in patients under one year old.
  • Mean DAP increased with reinsertion frequency, age, and weight; pulled tubes were the most common indication.

Conclusions:

  • Fluoroscopic NJT reinsertion is most frequent in younger, smaller pediatric patients.
  • Consideration of self-guided, bedside NJT insertion techniques is recommended.
  • Earlier initiation of definitive nutritional therapy may reduce the need for NJT reinsertions.

Keywords:
childrenfluoroscopynasojejunal tuberadiation doseself-guided technique

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