Stabilization of Nasoenteric Feeding Tubes Using Nasal Bridles In Paediatric Patients.

Abstract

Purpose: To determine if routine bridling of nasoenteric feeding tubes is a low-morbidity method of decreasing unintended tube dislodgement in pediatric patients. Methods: From November 2012 to June 2015, bridle systems were implemented in 30 pediatric patients with nasoenteric feeding tubes in place for an extended period of time, and data was prospectively collected. Historical cohort controls were 33 tracheoesophageal fistula (TEF) repair patients with taped nasoenteric tubes from 2001 to 2012. A second control group was 20 patients with nasoenteric tubes placed under fluoroscopy from February 2012 to July 2013. Analysis compared bridled children with these 2 groups to look at differences in total number tube dislodgements and tube dislodgements per 100 days. Complications related to bridle use were noted. Results: Among the 30 bridled patients, only 4 tube dislodgements were recorded in 1553 total days a tube was in place. During each of these instances, the bridle remained in place. There was a significant association between experimental group and total number tube dislodgements: only 3 of 30 bridled patients experienced tube dislodgements, compared to 18 of 33 TEF patients (p=0.0006) and 9 of 20 patients with fluoroscopically placed tubes (p=0.021). Children with bridled tubes experienced a lower rate of tube dislodgements per 100 days than TEF children with taped tubes (p<0.0001) and children with fluoroscopically placed taped tubes (p<0.0001). Aside from one child presenting with septum erosion and one report of patient fussiness, no complications related to bridle use were identified. Conclusion: We conclude that bridling of nasoenteric feeding tubes provides a safe and effective method of decreasing unintended tube dislodgement and optimizing nutritional delivery in pediatric patients.