Delivery of medications and nutritional support via an enteral route in critically ill patients is problematic, associated with risk, and often poorly tolerated. These drawbacks may be improved by post-pyloric (PP) position. Placement of a PP tube may require endoscopy or transport out of the ICU for fluoroscopic guidance. We sought to investigate whether staff critical care nurses using a modified technique could successfully place PP enteral feeding tubes at the bedside.
Critically ill patients without esophageal stricture or recent esophageal, gastric, head and neck, or neurosurgical surgery from two ICUs were enrolled prospectively in a pilot study to evaluate a bedside technique of PP feeding tube placement. Staff ICU nurses placed enteral feeding tubes following limited training of a modified placement technique.
A total of 101 patients were enrolled with an average age of 64 years. 57 of 101 patients were female. 63% of patients were receiving mechanical ventilation. Successful PP placement was established by radiographic confirmation in 84 patients ( 83%). Of the successful placements 75% (63 of 84) were done on the first of maximum two attempts. Average time spent for successful placement was 16 min, unsuccessful placement time spent 17 min. No significant complications were noted.
Successful placement of PP feeding tubes can be done at the bedside safely, quickly and in the majority of critically ill patients without complicated esophageal disease or recent select surgical procedures.
Post-pyloric feeding tubes may be placed in many critically ill patients without the need for fluoroscopy or endoscopy.
T.R. Aksamit, None.