How to Promote Bedside Placement of the Postpyloric Feeding Tube

Huang, Tongwang; Jing, Jiyong; Yan, Min

doi:10.1177/0148607114546166

Cited by 23 publications

(10 citation statements)

References 32 publications

(69 reference statements)

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“…The optimal method of achieving safe and effective postpyloric enteral access at the bedside remains controversial [ 10 ]. Both endoscopic and fluoroscopic assistance are deemed the most effective methods for postpyloric tube placement [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Blind bedside postpyloric placement of spiral tube as rescue therapy in critically ill patients: a prospective, tricentric, observational study

Chen

et al. 2017

Crit Care

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BackgroundVarious special techniques for blind bedside transpyloric tube placement have been introduced into clinical practice. However, transpyloric spiral tube placement facilitated by a blind bedside method has not yet been reported. The objective of this prospective study was to evaluate the safety and efficiency of blind bedside postpyloric placement of a spiral tube as a rescue therapy subsequent to failed spontaneous transpyloric migration in critically ill patients.MethodsThis prospective, tricentric, observational study was conducted in the intensive care units (ICUs) of three tertiary hospitals. A total of 127 consecutive patients with failed spontaneous transpyloric spiral tube migration despite using prokinetic agents and still required enteral nutrition for more than 3 days were included. The spiral tube was inserted postpylorically using the blind bedside technique. All patients received metoclopramide intravenously prior to tube insertion. The exact tube tip position was determined by radiography. The primary efficacy endpoint was the success rate of postpyloric spiral tube placement. Secondary efficacy endpoints were success rate of a spiral tube placed in the third portion of the duodenum (D3) or beyond, success rate of placement in the proximal jejunum, time to insertion, length of insertion, and number of attempts. Safety endpoints were metoclopramide-related and major adverse tube-associated events.ResultsIn 81.9% of patients, the spiral feeding tubes were placed postpylorically; of these, 55.1% were placed in D3 or beyond and 33.9% were placed in the proximal jejunum, with a median time to insertion of 14 min and an average number of attempts of 1.4. The mean length of insertion was 95.6 cm. The adverse event incidence was 26.0%, and no serious adverse event was observed.ConclusionsBlind bedside postpyloric placement of a spiral tube, as a rescue therapy subsequent to failed spontaneous transpyloric migration in critically ill patients, is safe and effective. This technique may facilitate the early initiation of postpyloric feeding in the ICU.Trial registrationChinese Clinical Trial Registry, ChiCTR-OPN-16008206. Registered on 1 April 2016.

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Section: Introductionmentioning

confidence: 99%

Blind bedside postpyloric placement of spiral tube as rescue therapy in critically ill patients: a prospective, tricentric, observational study

Chen

et al. 2017

Crit Care

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“…Elle peut cependant être discutée en cas d'intolérance digestive, pouvant permettre d'atteindre plus rapidement les objectifs nutritionnels [50] et d'améliorer la tolérance [22]. La technique de pose de la sonde en post-pylorique à l'aveugle semble donner de bons résultats [51]. En cas d'administration médicamenteuse, il faudra vérifier leurs propriétés phamacocinétiques (pouvant impacter l'absorption), et en cas de doute, les médicaments seront administrés en site gastrique.…”

Section: Modes D'administrationunclassified

Nutrition chez l'enfant : ce qui est important en réanimation pédiatrique

Moullet

Roux

Chaparro

et al. 2020

Méd. Intensive Réa.

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“…The use of a noninvasive electromagnetic device to place transpyloric feeding tubes has been suggested to be effective in children (64), although in another study it significantly increased the time of placement (65). Several studies showed that the insufflation of 10 mL/kg air in the stomach significantly improves the rate of success without increasing risks (66,67). A recent meta-analysis of all the RCTs both in adults and children concluded that gastric air insufflation seems to be efficient (without reaching significance), whereas clinicians should no longer use prokinetic agents in paediatric patients or patients without impaired motility (66,67).…”

Section: Domperidonementioning

confidence: 99%

“…Several studies showed that the insufflation of 10 mL/kg air in the stomach significantly improves the rate of success without increasing risks (66,67). A recent meta-analysis of all the RCTs both in adults and children concluded that gastric air insufflation seems to be efficient (without reaching significance), whereas clinicians should no longer use prokinetic agents in paediatric patients or patients without impaired motility (66,67). Bedside placement of a postpyloric tube can be safe and effective in infants including preterm and reduce infants' exposure to radiation in comparison to interventional radiology placement (68).…”

Section: Domperidonementioning

confidence: 99%