Document Detail


Evaluation of a bedside technique for postpyloric placement of feeding catheters.
MedLine Citation:
PMID:  19737119     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To establish the success rate, time taken and expertise required to place a feeding catheter into the small intestine using a device that permits real-time localisation of the catheter through detection of an electromagnetic field. DESIGN: Prospective observational study. SETTING: A tertiary, mixed medical-surgical, adult intensive care unit, between February 2008 and February 2009. PARTICIPANTS: 60 attempts at postpyloric intubation by eight clinicians (consultant and trainee intensivists and a dietitian) in 57 critically ill patients who were undergoing mechanical ventilation and were receiving, or suitable to receive, enteral nutrition. MAIN OUTCOME MEASURES: Patients were classified into an initial group (10 patients), who had the catheter placed by a single clinician to establish the most effective technique, and a subsequent group (50 patients), who had the catheter placed by any of the eight clinicians. Catheter position was confirmed on abdominal x-ray by an independent radiologist. RESULTS: Postpyloric catheter placement was successful in 56/60 attempts (93%), in 54/57 patients (95%), with a median time to placement of 7.2 min (interquartile range [IQR], 4.3-12.5 min). In the initial group, placement was successful in 7/10 attempts (70%), with a median time to placement of 20.8 min (IQR, 9.5-32.3 min), compared with 49/50 attempts (98%) and a median time of 5.9 min (IQR, 3.9-11.9 min) in the subsequent group (P = 0.003). CONCLUSIONS: An electromagnetically guided device enabled reliable and rapid bedside placement of small intestinal feeding catheters. Proficiency with the technique was quickly developed and successfully disseminated to a range of clinicians.
Authors:
Adam M Deane; Robert J Fraser; Robert J Young; Benita Foreman; Stephanie N O'Conner; Marianne J Chapman
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine     Volume:  11     ISSN:  1441-2772     ISO Abbreviation:  -     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-09-09     Completed Date:  2009-10-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100888170     Medline TA:  Crit Care Resusc     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  180-3     Citation Subset:  IM    
Affiliation:
Discipline of Anaesthesia and Intensive Care, University of Adelaide, Adelaide, SA. Adam.deane@adelaide.edu.au
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Catheterization, Peripheral / instrumentation*
Critical Illness / therapy*
Enteral Nutrition / instrumentation*
Equipment Design
Female
Follow-Up Studies
Humans
Intestine, Small
Male
Middle Aged
Point-of-Care Systems*
Prospective Studies
Radiography, Abdominal

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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