Evaluation of a technique for blind placement of post-pyloric feeding tubes in intensive care: application in patients with gastric ileus

Intensive Care Medicine
Andrew J LeeMark J Bennett

Abstract

To evaluate a blind 'active' technique for the bedside placement of post-pyloric enteral feeding tubes in a critically ill population with proven gastric ileus. An open study to evaluate the success rate and duration of the technique in cardiothoracic and general intensive care units of a tertiary referral hospital. 20 consecutive, ventilated patients requiring enteral nutrition, where feeding had failed via the gastric route. Previously described insertion technique-the Corpak 10-10-10 protocol-for post-pyloric enteral feeding tube placement, modified after 20 min if placement had not been achieved, by insufflation of air into the stomach to promote pyloric opening. A standard protocol and a set method to identify final tube position were used in each case. In 90% (18/20) of cases tubes were placed on the first attempt, with an additional tube being successfully placed on the second attempt. The median time for tube placement was 18 min (range 3-55 min). In 20% (4/20) insufflation of air was required to aid trans-pyloric passage. The previously described technique, modified by insufflation of air into the stomach in prolonged attempts to achieve trans-pyloric passage, proved to be an effective and cost efficient method to plac...Continue Reading

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Citations

Dec 8, 2010·Der Anaesthesist·J BraunY A Zausig
Feb 3, 2007·Current Opinion in Gastroenterology·Norma A MethenyRay E Clouse
May 7, 2015·Dysphagia·David SmithardStuart Elliot
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Nov 10, 2021·JPEN. Journal of Parenteral and Enteral Nutrition·Hongmei WangXuefeng Shan

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