Nasointestinal tube placement: Techniques that increase success

Taylor, Stephen; Sayer, Kaylee; White, Paul

Abstract

Background: Delayed gastric emptying (DGE) is a major cause of undernutrition that can be overcome using nasointestinal (NI) feeding, but tube placement often fails. We analyse which techniques enable successful NI tube placement. Methods: Efficacy of tube technique was determined at each of six anatomical points: Nose, nasopharynx-oesophagus, stomach-upper and -lower, duodenum part-1 and intestine. Results: In 913 first NI tube placements, significant associations with tube advancement were found in the pharynx (head tilt, jaw thrust, laryngoscopy), stomach_upper (air insufflation, 10cm or 20–30cm flexible tube tip ± reverse Seldinger manoeuvre), stomach_lower (air insufflation, possibly flexible tip and wire stiffener) and duodenum part-1 and beyond part-2 (flexible tip and combinations of micro-advance, slack removal, wire stiffener or prokinetic drugs). Conclusion: This is the first study to show what techniques are associated with tube advancement and the alimentary tract level they are specific to.

• Journal Article Type: Article
• Acceptance Date: Mar 23, 2022
• Online Publication Date: May 27, 2022
• Publication Date: 2023-02
• Deposit Date: Mar 23, 2022
• Publicly Available Date: Feb 17, 2023
• Journal: Journal of the Intensive Care Society
• Print ISSN: 1751-1437
• Publisher: SAGE Publications (UK and US)
• Peer Reviewed: Peer Reviewed
• Volume: 24
• Issue: 1
• Pages: 62-70
• DOI: https://doi.org/10.1177/17511437221095336
• Keywords: Delayed gastric emptying; manoeuvre; nasointestinal; nasojejunal; technique; tube advance
• Public URL: https://uwe-repository.worktribe.com/output/9233756
• Publisher URL: https://journals.sagepub.com/doi/10.1177/17511437221095336