Factors associated with fluoroscopy-guided placement of nasoenteral feeding tubes.

Abstract

Feeding by nasoenteral tube (NET) is safe and effective for supporting the nutrition needs of patients with inadequate oral intake. However, during insertion of the NET with fluoroscopic guidance, both the professional staff and patients are exposed to radiation. To improve the success rate of NET placement and minimize radiation exposure, this retrospective study evaluated potential factors associated with successful fluoroscopy-guided NET placement and short total fluoroscopy time (TFT) among Chinese patients. An assessment was conducted among patients (n = 348) who received NET placement by physicians under fluoroscopic guidance. Multivariate logistic regression models and linear models were used to validate factors that affected the success of placement and TFT. NET was placed successfully in 319 patients (91.7%), with a median TFT of 6.1 (interquartile range [IQR], 4.9-9.9) minutes. The median TFT of patients with unsuccessful placement was 15.4 (IQR, 12.7-20.9) minutes. Factors associated with successful placement included lack of upper gastrointestinal (GI) surgery history and normal peristalsis of the upper GI tract (P ≤ .015). The TFT was significantly influenced by upper GI surgery history and characteristics of the upper GI tract (P ≤ .025). The professional title or experience of the operators had no association with successful NET placement or TFT. NET placement under fluoroscopic guidance had a high success rate. Factors that are crucial for planning the approach include a history of upper GI surgery, the dynamic status of the upper GI tract, and features of the upper GI tract.