The Application of Electromagnetically Guided Post-pyloric Feeding Tube Placement in Critically Ill Patients

ABSTRACT

Background: Critically ill patients who demonstrate impaired gastric emptying benefit from post-pyloric enteral nutrition. However, correct placement of post-pyloric tube is challenging. Methods: In a retrospective, single center study, 142 critically ill patients were enrolled using electromagnetic technology. Our specialized team placed all post-pyloric tubes. Metoclopramide (10 mg) was infused 15 min prior to tube placement, and the tube tip location was confirmed by X-ray. Success rate for post-pyloric placement, implant time, time until EN initiation, and placement-related complications were measured. Results: 135 tubes in 142 patients were successfully placed during the first attempt, including 101 jejunal and 34 duodenal tubes. The average placement time was 20.12 min. The time from the physician order to the first tube placement attempt and EN administration was 3.6 and 7.5 hr, respectively. No placement-related complications were observed. Conclusions: Electromagnetic technology facilitates safe and effective post-pyloric feeding tube placement at the bedside in critically ill patients with impaired gastric emptying.

Keywords: :

• post-pyloric feeding
• enteral nutrition
• electromagnetic technology
• critical illness
• surgical critical illness
• impaired gastric emptying