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Original Research: CRITICAL CARE MEDICINE |

Endoscopic Placement of a Novel Feeding Tube

Hugh Black, MD, FCCP; Ken Yoneda, MD, FCCP; John Millar, MD; Jacqueline Allen, MD; Peter Belafsky, MD, MPH, PhD
Author and Funding Information

From the Department of Pulmonary and Critical Care Medicine (Drs Black and Yoneda), and the Department of Otolaryngology (Drs Allen and Belafsky), University of California, Davis, Sacramento, CA; and the Department of Pulmonary and Critical Care Medicine (Dr Millar), Kaiser Permanente, Vacaville, CA.

Correspondence to: Peter C. Belafsky, MD, MPH, PhD, Center for Voice and Swallowing, Department of Otolaryngology/HNS, University of California, Davis, 2521 Stockton Blvd, Ste 7200, Sacramento, CA 95817; e-mail: peter.belafsky@ucdmc.ucdavis.edu


Funding/Support: The feeding tube was developed by the senior author and supported by a Technology Transfer Grant from the University of California, Davis.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestpubs.org/site/misc/reprints.xhtml).


© 2010 American College of Chest Physicians


Chest. 2010;137(5):1028-1032. doi:10.1378/chest.09-2229
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Background:  Complications of blind feeding tube (FT) placement include pneumothorax, pneumonia, empyema, and death. A safe and effective method of FT placement is desired. The Davis FT is a novel device that detachably couples to an ultrathin transnasal gastroscope. The objective of this study was to evaluate the safety and efficacy of Davis FT placement.

Methods:  Fifty consecutive patients requiring transpyloric enteral tube feeding underwent placement of the Davis FT. Placement efficacy was evaluated with postplacement radiographs. Patient demographics, route of tube placement, use of sedation, and complications were abstracted.

Results:  The Davis FT was placed successfully in 50 patients. The mean age of the cohort was 52 (± 18) years. Sixty-two percent (31/50) were men. The success rate of nonpulmonary placement was 100% (50/50), and the postpyloric success rate was 96% (48/50). IV sedation was used in 72% (36/50) of placements. Eighty-six percent (43/50) of tubes were placed transnasally. The majority (62%) of esophagogastroduodenoscopies and Davis FT placements was performed by a pulmonologist. Forty-four percent (22/50) of patients had an endotracheal tube, 20% (10/50) had a tracheotomy, and 36% (18/50) had no breathing tube at the time of Davis FT placement. There were no complications.

Conclusions:  Transpyloric placement of the Davis FT is safe (100%) and effective (96%). The tube can be placed transorally or transnasally with or without sedation. The data suggest that postplacement radiographs are not necessary to confirm placement. Pulmonologists were successful in performing EGD and Davis FT placement.

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