Abstract
Objective The causes of unsuccessful nasointestinal tube placement in 9 patients with severe brain injury and gastric retention were analyzed and corrected. Methods The 9 cases of unsuccessful nasointestinal tube placement were analyzed from the aspects of disease, sedative drug use, mechanical ventilation, weakened bowel sounds and so on. Blind intubation was used to correct the defect, and the depth and time consumed of blind intubation and ultrasonic catheterization were compared. Results All 9 patients had gastric emptying disorders, decreased gastrointestinal peristalsis, and increased gastric residue, which affected the entrance of the catheter to the pylorus. Among them, 5 patients were given 3 or more sedative drugs in the state of drug sedation, and 2 patients had gastric emptying disorder due to the location of the disease damage. Therefore, ultrasound-guided nasointestinal tube placement was unsuccessful. Finally the 9 patients are successful to be inserted nasointestinal tubes by the blind placement plus air injection method. The average time of blind intubation was (28.89±13.80) min, which was lower than that of ultrasonic catheterization (84.44±20.07) min, and the difference was statistically significant (t=6.842, P<0.01) . Conclusions The failure of ultrasound-guided nasointestinal tube placement in patients with severe brain injury and gastric retention is related to the severity of the patient, the use of sedatives, mechanical ventilation, gastric retention and other causes of gastrointestinal peristalsis weakened or disappeared. Clinical nurses are required to give accurate assessment. Patients with severe brain injury and massive gastric retention are advised to use the blind placement plus air injection method for nasointestinal tube placement. In the case of ultrasound-guided nasointestinal tube placement, gastric motility drugs need to be used in advance. Key words: Nursing care; Brain injury; Gastroparesis; Nasointestinal tube placement; Ultrasound-guided; Blind placement plus air injection
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