Enteral Feeding Tube Placement Research Articles

Endoscopic placement of enteral feeding tubes: pediatric versus adult patients.

Endoscopic placement of enteral feeding tubes: pediatric versus adult patients.

Enteral feeding tube placement in obese patients: considerations for nutrition support.

Enteral feeding tube placement in obese patients: considerations for nutrition support.

Enteral Feeding Tube Placement in Head and Neck Cancer Patients: Special Considerations

Enteral Feeding Tube Placement in Head and Neck Cancer Patients: Special Considerations

Clinical application of endoscopic enteral feeding tube placement: A combined push and pull method

Clinical application of endoscopic enteral feeding tube placement: A combined push and pull method

Endoscopic clip-assisted placement of enteral feeding tubes

Reliable delivery of enteral feeding beyond the ligament of Treitz is desirable in a number of medical conditions. Post-pyloric enteral nutrition with concomitant gastric decompression in selected patients may reduce the risk of pulmonary aspiration of gastric contents, improve nutritional status, prevent gut mucosal atrophy, and reduce overall costs.1 Physicians are frequently frustrated in their effort to endoscopically deliver a feeding tube deep into the small bowel because of retrograde migration on withdrawal of the endoscope.

Laparoscopic insertion of the Moss feeding tube.

Placement of enteral feeding tubes is an important part of a surgeon's skill base. Surgical insertion of feeding tubes has been performed safely for many years with very few modifications. With the recent surge in interest and applicability of other laparoscopic procedures, it is well within the skills of the average laparoscopic surgeon to insert feeding tubes. We describe herein a simple technique for the insertion of the Moss feeding tube. The procedure described has a minimum of invasion, along with simplicity, safety, and accuracy.

Nasointestinal tube placement with a pH sensor feeding tube.

Radiographic confirmation of enteral feeding tube placement is a common practice representing considerable expense and causing delay in the initiation of enteral nutrition therapy. We evaluated an enteral feeding tube with a pH sensor, which allows immediate verification of the location of the tube by assessment of the pH upon insertion. Insertion pHs were obtained for 24 intensive care unit patients requiring feeding tube placement. Placement was verified radiographically and compared with expected location on the basis of the pH profile. The radiograph and the insertion pH profile were in agreement in 87.5% (21 of 24) of the cases. Concomitant use of histamine blockers did not affect the ability of the pH sensor to detect placement accurately (Fisher's Exact Test, p 5.71) Use of these pH measurements eliminates the need for radiographic documentation of placement, provides a savings for the patient, and may be beneficial in promoting enteral feedings in critically ill patients.

Enteral feeding tubes: placement by using fluoroscopy and endoscopy.

Fluoroscopy and endoscopy are both effective for guiding placement of enteral feeding tubes, but the relative advantages and limitations of the two methods are less clear. Consequently, we studied 104 consecutive patients referred for primary fluoroscopic placement of a Frederick-Miller feeding catheter. Success rate, fluoroscopic and room times, and tube position were determined. Unsuccessful fluoroscopic placement was followed immediately by an endoscopic attempt. The success rate for fluoroscopic placement was 90% (94/104), with the tube placed into the jejunum in 53% and into the duodenum in 47%. The fluoroscopic and room times for successful fluoroscopic placements were 8.6 +/- 5.6 min (mean +/- SD) and 21.7 +/- 8.4 min, respectively. For the 10 unsuccessful placements, the fluoroscopic and room times were 16.2 +/- 5.4 min (mean +/- SD) and 45.6 +/- 18.4 min, respectively. Both time differences were significant statistically. Endoscopic placement was successful in all seven patients in whom it was attempted, with a mean time of 13.4 min. The tubes placed endoscopically were in the jejunum in 29% and in the duodenum in 71%. Our results show that fluoroscopic and endoscopic placement of enteral feeding tubes is highly effective. Fluoroscopic time in successful cases is usually less than 15 min. Endoscopic placement of feeding tubes is successful after fluoroscopic failure.

The rapid placement of jejunal feeding tubes: the Setdinger technique applied to the gut

The jejunal placement of enteral feeding tubes can be quite difficult. There are three methods for positioning naso-enteral tubes or tubes placed through a gastrostomy. These require blind passage of a weighted tube into the stomach allowing peristalsis to propel the tube into the small intestine, radiographic placement with fluoroscopic manipulation, or endoscopic placement of the tube with direct vision techniques. 9 All methods have limitations. With duodenal placement, backwash of fluid or retrograde movement of the weighted feeding tube into the stomach can occur. Weighted tubes may require a few days to pass out of the stomach and placement beyond the ligament of Treitz is often not accomplished. Endoscopic placement often fails due to friction between the feeding tube and the endoscope as the latter is withdrawn. Placement of the feeding ports beyond the ligament of Treitz is the only method that will ensure that the tube will not fall back toward the stomach and that feeding will not reflux into the stomach. We have applied a guide wire technique to insert a 12 French feeding tube to achieve a rapid and reliable placement of jejunal tubes both naso-enterally and through pre-existing gastrostomies.

Bedside Enteral Feeding Tube Placement into Duodenum and Jejunum

Bedside Enteral Feeding Tube Placement into Duodenum and Jejunum

Bedside enteral feeding tube placement into duodenum and jejunum.

A bedside method for placement of nasoenteric feeding tubes is described utilizing gravity and corkscrewing of the feeding tube to pass the pylorus and then air injection to verify position of the tube from the location and character of transmitted sounds to the stethoscope. Twenty-eight of 31 consecutive patients requiring enteral feeding had tubes successfully placed past the pylorus using this method, 25 on the first attempt and three on the second. This method is an effective and inexpensive alternative to endoscopic or fluoroscopic feeding tube placement.

Endoscopic Placement of Enteral Feeding Tubes

The techniques for placement of feeding tubes using fiberscopes are described and an evaluation of the results obtained in the last 12 months is made. The techniques are discussed and compared with other methods of enteral feeding known at present. It is concluded that placement of feeding tubes by endoscopy can be achieved easily, that it is possible to choose the site of enteric liberation of nutrients under conditions which previously represented contraindications, and that this procedure is free of complications even during long periods of time.

Intranasal Retraction of Nasogastric Feeding Tube: Case Report and Suggestion for Design Modification

A 61-year-old black woman was admitted with intermittent small bowel obstruction following multiple therapies for recurrent ovarian carcinoma. Conservative enteric therapy with central hyperalimentation was begun prior to surgical intervention. After approximately 3 wk without resolution, surgical bypass of the obstructed area was performed for palliation. With the return of bowel function, continuous enteral feeding was utilized. During placement of enteral feeding tube, the proximal end spontaneously retracted into the patient's nasal cavity with associated patient distress. After some difficulty, the feeding tube was removed. Simple design modification of the proximal portion of the nasogastric feeding tube should prevent such complication. The addition of "wings" to the proximal end should be considered as a modification to prevent similar occurrences.