Objectives: Initiation of postpyloric feeding is often delayed by difficulties in placement of enteral tubes. We evaluated the effectiveness of bedside postpyloric enteral tube (PET) placement using an electromagnetic (EM)-guided device. We hypothesized that: 1) EM-guided placement of PETs would be successful more often than standard blind placement with a shorter total time to successful placement and 2) the EM-guided technique would have similar overall costs to the standard technique.
Design: Prospective cohort trial with serial control groups in a pediatric intensive care unit at a tertiary care children's hospital.
Interventions: We collected data on a cohort of consecutive pediatric intensive care unit patients who underwent PET placement by standard blind technique followed by a cohort who underwent EM-guided placement. The primary outcome measure was successful placement determined by abdominal radiography.
Measurements And Main Results: One hundred seven patients were evaluated in the trial: 57 in the standard group and 50 in the EM-guided group. Demographic data, percent intubated, and admission diagnosis were similar in both groups. Forty-one of 50 patients (82%) in the EM-guided group had successful placement compared with 22 of 57 in the standard group (38%) (p < 0.0001). The average time to successful placement was 1.7 vs. 21 hours in the EM-guided group and standard group, respectively (p < 0.0001). Children in the EM-guided group received fewer radiographs (p = 0.007) and were given more prokinetic drugs (p = 0.045). There were no episodes of pneumothorax in either group. After controlling for prokinetic drug use, EM-guided placement was more likely to result in successful placement than the standard blind technique (odds ratio 6.4, 95% confidence interval 2.5-16.3). An annual placement rate of 250 PETs by EM guidance, based on our institution's current utilization rates, is associated with a cost savings of $55.46 per PET placed.
Conclusion: EM guidance is an efficient and cost-effective method of bedside PET placement.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/PCC.0b013e31819a3668 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The Potential of Spinal Cord Stimulation in Treating Spinal Cord Injury.
Curr Pain Headache Rep
January 2025
Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL, 60657, USA.
Purpose Of The Review: In the United States, spinal cord injuries affect approximately 18,000 individuals annually, most commonly resulting from mechanical trauma. The consequent paraplegia severely impairs motor functions, creating an urgent need for innovative therapeutic strategies that extend beyond traditional rehabilitation and pharmacotherapy. This review assesses the effectiveness of Spinal Cord Stimulation (SCS) in improving motor function in patients with spinal cord injuries, with a particular focus on paraplegia.
View Article and Find Full Text PDFRe-intervention Utility After Endoscopic Ultrasound-Guided Hepaticogastrostomy Using a Partially Covered Stent with Anchoring Flange.
Dig Dis Sci
January 2025
Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Cheonan, Korea.
Background And Aim: Although long self-expandable metal stent (SEMS) with a sufficient intragastric portion is typically preferred for endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS), this design can complicate endoscopic re-intervention for recurrent biliary obstruction (RBO). We evaluated the efficacy and safety of endoscopic re-intervention for RBO through the stent after EUS-HGS using a novel partially covered SEMS with an anchoring flange.
Methods: The partially covered SEMS was designed with a intrahepatic uncovered portion measuring 1.
Background And Aim: Managing benign biliary stricture endoscopically is complicated and challenging. This study aimed to evaluate the safety and efficacy of a 6-month placement of a fully covered self-expanding metallic stent for refractory benign biliary stricture.
Methods: Twenty-two patients with refractory benign biliary stricture (13 with chronic pancreatitis and 9 without) were recruited from five higher tertiary care centers.
GBR assisted Onlay bone grafting for the posterior maxillary horizontal ridge augmentation: a case report and literature review.
Front Bioeng Biotechnol
January 2025
Hospital of Stomatogy, Jilin University, Changchun, China.
The posterior mandible is the primary area for occlusal function. However, long-term tooth loss in the posterior mandible often leads to rapid absorption of both buccal and lingual trabecular bone plates and subsequent atrophy of the alveolar ridge. This ultimately results in horizontal bone deficiencies that complicate achieving an optimal three-dimensional placement for dental implants.
View Article and Find Full Text PDFObservations of Score Changes Between USMLE Step 1 and Step 2 Among Students of Different Demographic Groups in a Longitudinal Clinical Curriculum.
J Med Educ Curric Dev
January 2025
Kirk Kerkorian School of Medicine at UNLV, Las Vegas, NV, USA.
Background: The transition of the United States Medical Licensing Examination Step 1 to a pass/fail scoring system is reshaping its role in medical students' residency placements. This compels institutions to rethink Step 2 preparation strategies, raising concerns about a clerkship's impact on various student groups. Traditionally, medical schools followed the traditional block rotation model for clerkships, which limits longitudinal learning, and many schools are switching to longitudinal integrated clerkships and longitudinal interleaved clerkships (LInCs).
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!