Login Register Cart 0
Generic placeholder image

Current Medical Imaging

Editor-in-Chief

ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Research Article

Electromagnetically Navigated Tube Placement Device for Bedside Placement of Small Bowel Feeding Tube on Patients with Acute Severe Pancreatitis: Comparative Study

Author(s): Guoliang Tan*, Yongming Chen and Yanping Lin

Volume 20, 2024

Published on: 06 October, 2023

Article ID: e110823219689 Pages: 6

DOI: 10.2174/1573405620666230811142726

Price: $65

Abstract

Background: A developing approach for the bedside installation of feeding tubes is the Electromagnetic Navigation-assisted Tube Placement Device (ENTPD). The ENTPD monitors the tip position of feeding tubes when they are inserted into the digestive tract. It aids in the avoidance of airway misalignment and allows placing into the small bowel. Several recent exploratory studies have shown that ENTPD for nasojejunal feeding tube installation can improve success rates, lower costs, and allow for a more rapid beginning of enteral nutrition.

Objectives: The aim of this study was to compare the effect of using an ENTPD for bedside placement of small bowel feeding tubes with blind placement on patients with acute severe pancreatitis and to see how well the electromagnetic navigation trajectory image (ENTI) and X-ray agreed on the location of the tube tip after placement.

Methods: The study was done prospectively using randomized and single-blind methods. The 65 cases used electromagnetic navigation-assisted placement, and 58 cases were blind placement. For judging the tube tip location, we compared the success rate, median time, number of repeat placements, complications, and agreement of ENTI vs. X-ray.

Results: The blind placement group's success rate was 86.21% compared to the ENTPD's 95.38%, P = 0.075. The median time was significantly longer in the blind placement group (116.55 ± 68.62 min vs. 25.37 ±12.63 min, P=0.000); the average number of repeating placements was 3.02 ± 1.21 vs. 1.16 ± 0.31 (Blind placement vs. ENTPD, P = 0.002). It provided a high degree of agreement between ENTI and X-ray after contrast, κ=0.752 [95% confidence interval, 0.67-0.84]. No complications occurred in the two groups.

Conclusion: ENTPD was used safely and effectively at the bedside to help patients with acute severe pancreatitis get feeding tubes. It not only improved the high successful rate of placement, decreased the time and reduced the exposure to X-ray, but it was also very convenient for bedside placement because of the portable equipment.

[1]
Pan LL, Li J, Shamoon M, Bhatia M, Sun J. Recent advances on nutrition in treatment of acute pancreatitis. Front Immunol 2017; 8: 762.
[http://dx.doi.org/10.3389/fimmu.2017.00762] [PMID: 28713382]
[2]
Jensen KB, Chan DL. Nutritional management of acute pancreatitis in dogs and cats. J Vet Emerg Crit Care 2014; 24(3): 240-50.
[http://dx.doi.org/10.1111/vec.12180] [PMID: 24690138]
[3]
de Aguilar-Nascimento JE, Kudsk KA. Clinical costs of feeding tube placement. JPEN J Parenter Enteral Nutr 2007; 31(4): 269-73.
[http://dx.doi.org/10.1177/0148607107031004269] [PMID: 17595433]
[4]
Lai C, Barlow R, Barnes M, Hawthorne AB. Bedside placement of nasojejunal tubes: A randomised-controlled trial of spiral- vs straight-ended tubes. Clin Nutr 2003; 22(3): 267-70.
[http://dx.doi.org/10.1016/S0261-5614(02)00210-8] [PMID: 12765666]
[5]
Zaloga GP, Roberts PR. Bedside placement of enteral feeding tubes in the intensive care unit. Crit Care Med 1998; 26(6): 987-8.
[http://dx.doi.org/10.1097/00003246-199806000-00007] [PMID: 9635639]
[6]
Jimenez LL, Ramage JE Jr. Benefits of postpyloric enteral access placement by a nutrition support dietitian. Nutr Clin Pract 2004; 19(5): 518-22.
[http://dx.doi.org/10.1177/0115426504019005518] [PMID: 16215148]
[7]
Ugo PJ, Mohler PA, Wilson GL. Bedside postpyloric placement of weighted feeding tubes. Nutr Clin Pract 1992; 7(6): 284-7.
[http://dx.doi.org/10.1177/0115426592007006284] [PMID: 1289702]
[8]
Rivera R, Campana J, Hamilton C, Lopez R, Seidner D. Small bowel feeding tube placement using an electromagnetic tube placement device: Accuracy of tip location. JPEN J Parenter Enteral Nutr 2011; 35(5): 636-42.
[http://dx.doi.org/10.1177/0148607110386047] [PMID: 21844241]
[9]
Powers J, Luebbehusen M, Aguirre L, et al. Improved safety and efficacy of small-bore feeding tube confirmation using an electromagnetic placement device. Nutr Clin Pract 2018; 33(2): 268-73.
[http://dx.doi.org/10.1002/ncp.10062] [PMID: 29529335]
[10]
Phang J, Marsh W, Prager R. Feeding tube placement with the aid of a new electromagnetic transmitter. JPEN J Parenter Enteral Nutr 2006; 30: S48-9.
[11]
Sorokin R, Gottlieb JE. Enhancing patient safety during feeding-tube insertion: A review of more than 2,000 insertions. JPEN J Parenter Enteral Nutr 2006; 30(5): 440-5.
[http://dx.doi.org/10.1177/0148607106030005440] [PMID: 16931614]
[12]
Gabriel S, Ackermann R, Gabriel S, Ackermann C, Swadener-Culpepper L. Evaluation of a nasoenteral feeding tube with balloon to facilitate placement. Crit Care Nurse 2020; 40(1): 37-44.
[http://dx.doi.org/10.4037/ccn2020845] [PMID: 32006034]
[13]
Slingerland-Boot R, Bouw-Ruiter M, van Manen C, Arbous S, van Zanten A. Video-assisted placement of enteral feeding tubes using the integrated real-time imaging system (IRIS)-technology in critically ill patients. Clin Nutr 2021; 40(8): 5000-7.
[http://dx.doi.org/10.1016/j.clnu.2021.07.026] [PMID: 34364239]
[14]
Smithard D, Barrett NA, Hargroves D, Elliot S. Electromagnetic sensor-guided enteral access systems: A literature review. Dysphagia 2015; 30(3): 275-85.
[http://dx.doi.org/10.1007/s00455-015-9607-4] [PMID: 25943295]
[15]
Gerritsen A, de Rooij T, Dijkgraaf MG, et al. Electromagnetic-guided bedside placement of nasoenteral feeding tubes by nurses is non-inferior to endoscopic placement by gastroenterologists: A multicenter randomized controlled trial. Am J Gastroenterol 2016; 111(8): 1123-32.
[http://dx.doi.org/10.1038/ajg.2016.224] [PMID: 27272012]
[16]
Watanabe J, Kakehi E, Okamoto M, Ishikawa S, Kataoka Y. Electromagnetic-guided versus endoscopic-guided postpyloric placement of nasoenteral feeding tubes. Cochrane Database Syst Rev 2022; 10(10): CD013865.
[17]
Banks PA, Bollen TL, Dervenis C, et al. Classification of acute pancreatitis—2012: Revision of the Atlanta classification and definitions by international consensus. Gut 2013; 62(1): 102-11.
[http://dx.doi.org/10.1136/gutjnl-2012-302779] [PMID: 23100216]
[18]
Carter M, Roberts S, Carson JA. Small-bowel feeding tube placement at bedside: Electronic medical device placement and X-Ray agreement. Nutr Clin Pract 2018; 33(2): 274-80.
[http://dx.doi.org/10.1002/ncp.10072] [PMID: 29532510]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy