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Nasointestinal tube placement: Techniques that increase success.

Stephen J Taylor1, Kaylee Sayer1, Paul White2

  • 1Department of Nutrition and Dietetics, Southmead Hospital Bristol, Bristol, UK.

Journal of the Intensive Care Society
|March 6, 2023
PubMed
Summary

Successful nasointestinal (NI) tube placement, crucial for overcoming delayed gastric emptying (DGE), can be improved by specific techniques at different anatomical points. This study identifies key methods for advancing NI tubes effectively.

Keywords:
Delayed gastric emptyingmanoeuvrenasointestinalnasojejunaltechniquetube advance

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Area of Science:

  • Medical devices
  • Gastroenterology
  • Clinical nutrition

Background:

  • Delayed gastric emptying (DGE) is a significant cause of undernutrition.
  • Nasointestinal (NI) feeding is effective for DGE but faces challenges with tube placement.
  • Optimizing NI tube placement techniques is essential for nutritional support.

Purpose of the Study:

  • To identify techniques associated with successful nasointestinal tube advancement.
  • To determine the anatomical specificity of these techniques.

Main Methods:

  • Analysis of 913 first-time nasointestinal tube placements.
  • Evaluation of tube technique efficacy at six anatomical points: nose, nasopharynx-esophagus, upper and lower stomach, duodenum part-1, and intestine.
  • Correlation of specific maneuvers and device features with successful tube advancement.

Main Results:

  • Successful advancement through the pharynx was associated with head tilt, jaw thrust, and laryngoscopy.
  • Upper stomach advancement involved air insufflation and specific flexible tube tip manipulations.
  • Lower stomach and duodenum advancement utilized flexible tips, wire stiffeners, and prokinetic drugs.

Conclusions:

  • This study provides the first evidence linking specific techniques to successful NI tube advancement.
  • Techniques are specific to the anatomical level within the alimentary tract.
  • Findings can guide clinicians to improve NI tube placement success rates.