Implementation of an electromagnetic imaging system to facilitate nasogastric and post‐pyloric feeding tube placement in patients with and without critical illness

Windle, E. M.; Beddow, David; Hall, Ellis H.; Wright, Janine; Sundar, N Mani

doi:10.1111/j.1365-277x.2009.01010.x

Cited by 38 publications

(37 citation statements)

References 11 publications

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“…Various combinations of key words used in the search included electromagnetic phenomena, enteral nutrition, instrumentation, gastrointestinal, point-ofcare testing, pneumothorax, and Cortrak. Fifteen published studies 1,[4][5][6][7][8][9][10][11][12][13][14][15][16][17] were found that evaluated the effectiveness of an ETP device in determining tube location. These studies were reviewed for any reference to detection of bronchopulmonary placements.…”

Section: Methodsmentioning

confidence: 99%

“…3 Researchers in multiple studies have evaluated the effectiveness of an electromagnetic tube placement (ETP) device in distinguishing between tube placement in the stomach and in the small bowel. 1,[4][5][6][7][8][9][10][11][12][13][14][15][16][17] However, fewer studies have involved evaluation of the effectiveness of an ETP device in detecting bronchopulmonary placements. 1,6,11,12,14,16 Purpose This study had 2 purposes: 1.…”

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confidence: 99%

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Effectiveness of an Electromagnetic Feeding Tube Placement Device in Detecting Inadvertent Respiratory Placement

Metheny

Meert

2014

American Journal of Critical Care

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Background Use of technology capable of electromagnetically tracking advancement of a feeding tube on a monitoring screen during insertion may enable detection of deviation of the tube from the midline as it advances through the chest, possibly indicating entry of the tube into the right or left main bronchus. Purposes To describe (1) published peer-reviewed studies that report on the detection of malpositioned tubes inserted by an electromagnetic tube placement device, and (2) events reported to the US Food and Drug Administration’s Manufacturer and User Facility Device Experience (MAUDE) database regarding use of such a device. Methods An Ovid MEDLINE search was conducted to locate peer-reviewed studies published between 2007 and 2012 that referred to use of an electromagnetic tube placement device to detect inadvertent respiratory placements of feeding tubes. In addition, an online search of the MAUDE database was conducted for the years 2007 through 2012. Results The Ovid MEDLINE search yielded 6 studies that referred to respiratory placements; no cases of pneumothorax were reported. The MAUDE database search yielded 21 adverse events associated with use of an electromagnetic tube placement device (including 17 cases of pneumothorax and 2 deaths). As the MAUDE database relies on voluntary reports, this number should not be construed as the incidence of malpositioned tubes during this period. Conclusions The ability of clinicians to place feeding tubes correctly by using an electromagnetic tube placement device varies. Thus, it is reasonable to question the wisdom of eliminating radiographic confirmation of tube position before starting feedings.

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Section: Methodsmentioning

confidence: 99%

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confidence: 99%

Effectiveness of an Electromagnetic Feeding Tube Placement Device in Detecting Inadvertent Respiratory Placement

Metheny

Meert

2014

American Journal of Critical Care

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“…This method has been used with success in patients with previously difficult access 60 and is cost-effective, reducing X-ray exposure and time to initiation of enteral feeding.…”

Section: -59mentioning

confidence: 99%

Interruptions in Enteral Nutrition Delivery in Critically Ill Patients and Recommendations for Clinical Practice

Stewart

2014

Critical Care Nurse

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M alnutrition results when nutritional intake does not meet metabolic requirements. Critically ill patients are at an increased risk for malnutrition because of alterations in protein and energy metabolism displayed in response to trauma, major surgery, burns, and sepsis 1 and may be unable to tolerate oral nutrition. Critical care nurses are well positioned to screen patients at risk for malnutrition and to work in conjunction with the multidisciplinary team to develop and implement interventions to prevent and treat malnutrition. Interruptions in Enteral Nutrition Delivery in Critically Ill Patients and Recommendations for Clinical Practice MELISSA L. STEWART, RN, DNP, MSN, CCNS, CCRNThis article has been designated for CNE credit. A closed-book, multiple-choice examination follows this article, which tests your knowledge of the following objectives:1. List consequences of malnutrition in critically ill patients 2. Discuss how current nursing routines may contribute to interruptions in enteral nutrition in critically ill patients 3. Describe nursing interventions to improve the delivery of nutrition to critically ill patients CNE Continuing Nursing EducationCover Malnutrition is common in critically ill patients and is associated with poor outcomes for patients and increased health care spending. Enteral nutrition is the method of choice for nutrition delivery. Enteral nutrition delivery practices vary widely, and underfeeding is widespread in critical care. Interruptions in enteral nutrition due to performance of procedures, positioning, technical issues with feeding accesses, and gastrointestinal intolerance contribute to underfeeding. Strategies such as head-of-bed positioning, use of prokinetic agents, tolerance of higher gastric residual volumes, consideration of postpyloric feeding access, and use of a nutrition support protocol may decrease time spent without nutrition. (Critical Care Nurse.

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“…The implementation of a new strategy for confirming correct tube placement requires good nursing education, compliance and multidisciplinary team work. Windle et al [88] used an electromagnetic imaging system in order to assess the correct placement of NGTs and showed that this method has some advantages, especially in confirming the post-pyloric placement of an NGT even at the early stage of implementation.…”

Section: Assessment Of Correct Placementmentioning

confidence: 99%

Nasogastric tube insertion in anaesthetized patients: a comprehensive review

Sanaie

Mahmoodpoor

Najafi

2017

Anaesthesiol Intensive Ther

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Nasogastric tubes (NGT) still remain the easiest and the best way for gastrointestinal tract access. There are various indications for the insertion of a nasogastric tube in anaesthetized and critically ill patients. Although many techniques have been introduced to facilitate nasogastric tube insertion using anatomic landmarks and a group of devices, there is no consensus on a standard method. Moreover, there are different methods for the assessment of the correct placement of a nasogastric tube. In addition to these challenges in insertion and assessment methods, there are varieties of major life-threatening and minor complications to be addressed. Thus, selecting the most appropriate approach requires enough knowledge in this area, considering patient condition and clinical factors, as well as the practitioners' sufficient education and experience, along with skill in performance. This is a comprehensive review of the literature evidence on different methods for nasogastric tube insertion, on the assessment of correct placement and the evaluation of complications, in addition to an approach to the effect of education on the quality of routine practice and patients' outcome.

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Implementation of an electromagnetic imaging system to facilitate nasogastric and post‐pyloric feeding tube placement in patients with and without critical illness

Cited by 38 publications

References 11 publications

Effectiveness of an Electromagnetic Feeding Tube Placement Device in Detecting Inadvertent Respiratory Placement

Effectiveness of an Electromagnetic Feeding Tube Placement Device in Detecting Inadvertent Respiratory Placement

Interruptions in Enteral Nutrition Delivery in Critically Ill Patients and Recommendations for Clinical Practice

Nasogastric tube insertion in anaesthetized patients: a comprehensive review

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