Placement of a Jejunal Feeding Tube via an Ultrasound-Guided Antral Progressive Water Injection Method

Abstract

Background:Jejunal feeding tube allows the nutrition of critical care patients more easy and safe. However, its placement remains a challenge. This study aimed to introduce a jejunal feeding tube through an ultrasound-guided antral progressive water injection method and subsequently to examine its efficacy.Methods:Between April 2016 and April 2017, 54 patients hospitalized in the Department of Critical Care Medicine, Peking Union Medical College Hospital, China who needed nutritional support through a jejunal feeding tube were recruited for this study. Patients who applied ultrasound-guided antral progressive water injection method were classified into the experimental group. Patients who applied conventional method were registered as control group.Results:No significant differences were found in age, body mass index, and Acute Physiology and Chronic Health Evaluation score, but a significant difference in operation time was found between the experimental group and the control group. Of the 24 individuals in the control group, 17 displayed clear catheter sound shadows once the tube entered the esophagus. In comparison, of the 30 individuals in the experimental group, all harbored catheter sound shadows through the esophageal gas injection method. Subsequent observation revealed that in the control group (via ultrasonographic observation), 15 individuals underwent successful antral tube entry, for a success rate of 63%. In the experimental group (via antral progressive water injection), 27 individuals underwent successful antral tube entry, for a success rate of 90%. There was a significant difference between the success rates of the two groups (χ2 = 5.834, P = 0.022).Conclusion:The antral progressive water injection method for the placement of a jejunal feeding tube is more effective than the traditional ultrasonic placement method.

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“…Similarly, ultrasound was useful to the placement of the jejuna nutrition tube [3]. The application of ultrasound helps to avoid risks and optimize care procedures.…”

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“…A interposição de gás é apontada em diversos estudos como um fatorque pode dificultar a avaliação do trato gastrointestinal por meio da US (9,10,12,20,31,32) .O que se deve às características da US: ondas sonoras de alta frequência penetram os tecidos e são por eles refletidas. Ao retornar para o transdutor essas ondas são convertidas em imagens.…”

Development of a Competency Model for Placement and Verification of Nasogastric and Nasoenteric Feeding Tubes for Adult Hospitalized Patients

“…A few studies have demonstrated accuracy with this technique. 57,58,78 However, a systematic Cochrane Review from 2017 identified 10 studies (545 participants and 560 tube insertions) that met inclusion criteria. Ultrasound did not have sufficient accuracy as a single test to confirm gastric tube placement.…”

“…Another technology for determining feeding tube tip location includes the use of ultrasound. A few studies have demonstrated accuracy with this technique 57,58,78 . However, a systematic Cochrane Review from 2017 identified 10 studies (545 participants and 560 tube insertions) that met inclusion criteria.…”