Nasointestinal tube placement: Techniques that increase success.

J Intensive Care Soc

Mathematics and Statistics Research Group, University of the West of England, Bristol, UK.

Published: February 2023

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.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9975804PMC
http://dx.doi.org/10.1177/17511437221095336DOI Listing

Publication Analysis

Top Keywords

tube placement
8
duodenum part-1
8
tube advancement
8
air insufflation
8
wire stiffener
8
tube
7
nasointestinal tube
4
placement techniques
4
techniques increase
4
increase success
4

Similar Publications

The Centers for Medicare & Medicaid Services (CMS) recently increased payment for evaluation and management (E/M) visits, but did not apply these updates to post-operative global period visits. We investigated the resulting Medicare fee-for-service revenue loss for otolaryngologists. Using publicly available Medicare spending/utilization data, we estimated how much additional payment otolaryngologists would have received in 2023 if CMS had reimbursed global period visits at the same rates as other E/M visits.

View Article and Find Full Text PDF

: Video-assisted thoracoscopic surgery (VATS) is associated with less postoperative pain than traditional open thoracotomy. However, trocar and chest tube placement may damage the intercostal nerves, causing significant discomfort. An ultrasound-guided serratus anterior plane block (SAPB) is a promising mode of pain management; this reduces the need for opioids and the associated side-effects.

View Article and Find Full Text PDF

Background: The role of beta-blockers in severe, traumatic brain injury (TBI) management is debated. Severe TBI may elicit a surge of catecholamines, which has been associated with increased morbidity and mortality. We hypothesize administering propranolol, a non-selective beta-blocker, within 48 h of TBI will reduce patient mortality within 30 days of injury.

View Article and Find Full Text PDF

Subcutaneous emphysema results from air or gas being forced into the fascial spaces of subcutaneous tissue. Once the air or gas has entered the fascial spaces, it travels along connective tissue causing a mass effect and swelling. This rare complication usually presents with mild severity during the immediate postoperative period following surgical procedures of the head or neck regions and self-resolves with conservative treatment.

View Article and Find Full Text PDF

Purpose: Adrenocortical carcinoma (ACC) is a rare, aggressive pediatric malignancy. Advanced ACC requires multimodal treatment, including surgery and systemic chemotherapy including cisplatin, etoposide, doxorubicin, and mitotane. This is associated with significant gastrointestinal toxicity, resulting in many patients being unable to complete scheduled therapy.

View Article and Find Full Text PDF

Want 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!