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Bedside placement of pH-guided transpyloric small bowel feeding tubes in critically ill infants and small children
R J Dimand1, G Veereman-Wauters, D A Braner
1Section of Critical Care Medicine, University of California, San Francisco, USA.
Insights
pH-guided jejunal tube placement is a safe and effective method for critically ill infants and children. This bedside technique offers an easy alternative for jejunal feeding in pediatric patients.
Area of Science:
- Pediatric critical care medicine
- Gastroenterology
- Medical device technology
Background:
- Critically ill infants and children often require jejunal feeding for nutritional support.
- Traditional methods for jejunal tube placement (fluoroscopic, endoscopic, surgical) can be invasive and resource-intensive.
Purpose of the Study:
- To evaluate the safety and efficacy of pH-guided jejunal tube placement in critically ill pediatric patients.
- To establish pH-guided placement as a feasible bedside alternative.
Main Methods:
- A soft feeding tube with a distal pH sensor was used to cannulate the small bowel.
- Tube placement was guided by monitoring pH changes as the tube traversed the stomach into the small bowel.
Main Results:
- Successful placement was achieved in 97% (36 of 37) of attempts in 29 critically ill infants and children.
- Continuous jejunal feedings were administered for an average of 3.7 weeks without complications in all but one patient.
Conclusions:
- pH-guided jejunal tube placement is a safe and easy bedside alternative for critically ill infants and children.
- This method simplifies jejunal feeding access, reducing the need for more invasive procedures.
Background And Methods:
The small bowel of critically ill infants and small children was cannulated using a soft feeding tube with a pH sensor at the distal tip. By monitoring pH, the tubes were guided through the stomach into the small bowel.
Results:
Successful placements were performed in 36 of 37 (97%) attempts in 29 critically ill patients whose age was 7.9 +/- 6.3 months and weight was 5.9 +/- 2.6 kg. Continuous jejunal feedings were administered for 3.7 +/- 3.1 weeks without difficulties or complications in all but one patient.
Conclusion:
pH-guided jejunal tube placement provides a safe, easy bedside alternative to fluoroscopic, endoscopic or surgical placement in critically ill infants and small children.