Nasointestinal tube placement: Techniques that increase success. (February 2023)

• Record Type: Journal Article
• Authors: Taylor, Stephen J; Sayer, Kaylee; White, Paul
• Is Part Of: Journal of the Intensive Care Society. Volume 24:Number 1(2023)
• Page Start: 62
• Page End: 70
• Publication Date: 2023-02
• Subjects: Delayed gastric emptying -- manoeuvre -- nasointestinal -- nasojejunal -- technique -- tube advance; Critical care medicine -- Periodicals; Intensive care units -- Periodicals; 616.028
• DOI: 10.1177/17511437221095336
• Languages: English
• ISSNs: 1751-1437

Abstract

Background: Delayed gastric emptying (DGE) is a major cause of undernutrition that can be overcome using nasointestinal (NI) feeding, but tube placement often fails. We analyse which techniques enable successful NI tube placement. Methods: Efficacy of tube technique was determined at each of six anatomical points: Nose, nasopharynx-oesophagus, stomach-upper and -lower, duodenum part-1 and intestine. Results: In 913 first NI tube placements, significant associations with tube advancement were found in the pharynx (head tilt, jaw thrust, laryngoscopy), stomach_upper (air insufflation, 10 cm or 20–30 cm flexible tube tip ± reverse Seldinger manoeuvre), stomach_lower (air insufflation, possibly flexible tip and wire stiffener) and duodenum part-1 and beyond part-2 (flexible tip and combinations of micro-advance, slack removal, wire stiffener or prokinetic drugs). Conclusion: This is the first study to show what techniques are associated with tube advancement and the alimentary tract level they are specific to.