Safety and effectiveness of the nasal bridle securement device to retain feeding tubes in adult patients in the intensive care unit: An observational study

Abstract

Background: Nasal bridle securement devices were introduced to our adult intensive care unit (ICU) in October 2016 as an alternative for securing small-bore feeding tubes in patients at higher risk of inadvertent tube dislodgement. Method:We assessed high-risk ICU patients from October 2014 to March 2019 to address three objectives. First, we prospectively monitored ICU patients with a nasal bridle for all types of adverse events. Second, we used propensity score methods to create a (1:1) matched historical comparison group (ie, tape group). We then compared the number of inadvertent tube dislodgements and the caloric intake between the tape and nasal bridle groups.Results: In the prospective group (n = 64), there were 20 adverse events, 12 of which were inadvertent tube dislodgements. Forty-eight participants in the nasal bridle group were matched with participants in the historical group. Thirty-five percent (17/48) of patients in the tape group had at least one inadvertent tube dislodgement; in the nasal bridle group, 48% (23/48) had at least one inadvertent tube dislodgement, although this only occurred in 7 of 48 (15%) patients after the nasal bridle had been inserted.The tape group achieved a lower median percentage of total caloric intake received (66.0%) compared with that of the nasal bridle group (86.1%; P = 0.017).Conclusions: In the subpopulation of ICU patients with a small-bore feeding tube who demonstrate a higher risk of inadvertent tube dislodgement, use of the nasal bridle may be associated with a higher caloric intake, even though it does not completely prevent tube dislodgement.

Complicações relacionadas às sondas enterais de curta permanência

“…Ao todo foram identificados 331 artigos e a partir dos critérios de elegibilidade, onze estudos foram incluídos para análise sendo a maioria publicados nos Estados Unidos (11)(12)(13) , Brasil (14)(15)(16) , Austrália (17) , Bélgica (18) , Canadá (19) , China (20) e Inglaterra (21) .…”

“…A maioria dos artigos foi publicada em revistas de medicina e nutrição hospitalar (11,(13)(14)(16)(17)19) .…”

“…A principal complicação relacionada ao uso de sonda enteral foi a retirada acidental da sonda (14)(15)(16)19,21) , seguida da obstrução da sonda (11)(12)(14)(15) e desposicionamento da ponta da sonda (14,(17)(18)(19)(20) . Como descrito no quadro 2.…”

“…Tabela 1 -Categorias das complicações evidenciadas nos estudos incluídos para análise (N=11). Rio de Janeiro, 2024 (14)(15)(16)(17)19,21) . (11)(12)(14)(15) .…”

“…(11)(12)(14)(15) . (14,(17)(18)(19)(20) (13,17) . 2 18,2 Epistaxe/hemorragia nasal Anziliero e Beghetto (2022), Rabaut et al (2022) (14,17) .…”