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Electromagnetically guided bedside placement of post-pyloric feeding tubes in critical care

Danielle E Bear1, Alice Champion2, Katie Lei3

  • 1Principal Critical Care Dietitian, Department of Critical Care and Department of Nutrition and Dietetics, Guy's and St Thomas' NHS Foundation Trust, London.

British Journal of Nursing (Mark Allen Publishing)
|October 17, 2017
PubMed

Insights

Placing post-pyloric feeding tubes (PPFTs) in critically ill patients using an electromagnetic device is highly successful and safe. This method avoids lung placements and facilitates timely enteral feeding.

Area of Science:

  • Critical Care Medicine
  • Gastroenterology
  • Medical Devices

Background:

  • Post-pyloric feeding tubes (PPFTs) are crucial for critically ill patients with gastrointestinal intolerance.
  • Traditional PPFT placement methods are logistically challenging and pose risks.

Purpose of the Study:

  • To evaluate the efficacy and safety of an electromagnetic device for bedside PPFT placement.
  • To compare outcomes with traditional methods, including success rates, complications, and time to feeding.

Main Methods:

  • Retrospective analysis of 40 PPFT placements in 37 mechanically ventilated patients.
  • Utilized an electromagnetic device for placement, with X-ray confirmation.
  • Assessed complication rates, lung placement avoidance, and time to enteral feeding.

Main Results:

  • Achieved an 87.5% success rate for PPFT placement.
  • Electromagnetic device demonstrated 77% sensitivity and 100% specificity for correct placement.
  • Successfully identified and avoided 5 lung placements in real-time.
  • Mean time to X-ray was 134 minutes; mean time to feeding was 276 minutes.

Conclusions:

  • Bedside placement of PPFTs using an electromagnetic device is a safe and feasible option for mechanically ventilated patients.
  • This technique offers a high success rate and effectively prevents potentially dangerous lung placements.

Keywords:
Critical illnessEnteral accessEnteral nutritionGastrointestinal accessNutrition

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