A Randomized Controlled Trial Comparing Three Different Techniques of Nasojejunal Feeding Tube Placement in Critically Ill Children

Phipps, Lorri M.; Weber, Mark; Ginder, Beth R.; Hulse, Michael A.; Thomas, Neal J.

doi:10.1177/0148607105029006420

Cited by 25 publications

(19 citation statements)

References 26 publications

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“…It remains unclear if transpyloric feedings decrease aspiration risk in all patients; however, they are preferable in patients who have significantly slowed gastric motility. A recent study [32] suggests that operator skill may be a more important factor in achieving small-bowel tube insertions at the bedside than is the specific method used to place the tube.…”

Section: Resultsmentioning

confidence: 99%

“…A variety of techniques are available to facilitate bedside placement of small-bowel tubes without specialized equipment. A core of experienced nurses and physicians compared the efficacy of three methods (standard technique, standard technique with air insufflation, and standard technique with erythromycin) in a group of critically ill children [32]. They successfully achieved small-bowel placement in 71 of 75 patients on the first or second attempt.…”

Section: Aspirationmentioning

confidence: 99%

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Complications related to feeding tube placement

Metheny

Meert

Clouse

2007

Current Opinion in Gastroenterology

145

122

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Section: Resultsmentioning

confidence: 99%

Section: Aspirationmentioning

confidence: 99%

Complications related to feeding tube placement

Metheny

Meert

Clouse

2007

Current Opinion in Gastroenterology

145

122

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“…Other approaches include gastric insufflation (61,62), magnetic-assisted placement (63), and a combination of other techniques coupled with electromyographic guidance (64,65). Even with the use of sophisticated techniques, the success rates have not surpassed 75% to 80% (65,66).…”

Section: Nasoduodenal or Nasojejunal Tubesmentioning

confidence: 99%

Practical Approach to Paediatric Enteral Nutrition: A Comment by the ESPGHAN Committee on Nutrition

Braegger

Décsi

Dias

et al. 2010

J. pediatr. gastroenterol. nutr.

249

254

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Enteral nutrition support (ENS) involves both the delivery of nutrients via feeding tubes and the provision of specialised oral nutritional supplements. ENS is indicated in a patient with at least a partially functioning digestive tract when oral intake is inadequate or intake of normal food is inappropriate to meet the patients' needs. The aim of this comment by the Committee on Nutrition of the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition is to provide a clinical practice guide to ENS, based on the available evidence and the clinical expertise of the authors. Statements and recommendations are presented, and future research needs highlighted, with a particular emphasis placed on a practical approach to ENS.Among the wide array of enteral formulations, standard polymeric feeds based on cow's-milk protein with fibre and age adapted for energy and nutrient content are suitable for most paediatric patients. Whenever possible, intragastric is preferred to postpyloric delivery of nutrients, and intermittent feeding is preferred to continuous feeding because it is more physiological. An anticipated duration of enteral nutrition (EN) exceeding 4 to 6 weeks is an indication for gastrostomy or enterostomy. Among the various gastrostomy techniques available, percutaneous endoscopic gastrostomy is currently the first option. In general, both patients and caregivers express satisfaction with this procedure, although it is associated with a number of well-recognised complications. We strongly recommend the development and application of procedural protocols that include scrupulous attention to hygiene, as well as regular monitoring by a multidisciplinary nutrition support team to minimise the risk of EN-associated complications.

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“…A total of 545 citations were identified from the literature search. Fourteen studies 5 ‐ 7 , 20 ‐ 30 involving 753 patients met our inclusion criteria. The other studies were excluded for various reasons (Figure 1).…”

Section: Resultsmentioning

confidence: 99%