| Transnasal endoscopic placement of nasoenteric feeding tubes: outcomes and limitations in non-critically ill patients. | |
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MedLine Citation:
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PMID: 18390786 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Transnasal endoscopic placement of nasoenteric tubes (NETs) has been demonstrated to be useful in the critical care setting, with limited data on its role in non-critically ill patients. The authors collected data on consecutive patients from a non-critical care setting undergoing transnasal endoscopic NET placement. All NETs were endoscopically placed using a standard over-the-guidewire technique, and positions were confirmed with fluoroscopy. Patients were monitored until the removal of NETs or death. Twenty-two patients (median age = 62.5 years, 36.4% female) were referred for postpyloric feeding, with main indications of persistent gastrocutaneous fistula (n = 6), gastroparesis or gastric outlet obstruction (n = 5), duodenal stenosis (n = 6), acute pancreatitis (n = 4), and gastroesophageal reflux after surgery (n = 1). Postpyloric placement of NET was achieved in 19 of 22 (86.3%) patients, with 36.8% tube positions in the jejunum, 47.4% in the distal duodenum, and 15.8% in the second part of the duodenum. NET placement was least successful in cases with duodenal stenosis. NETs remained in situ for a median of 24 days (range, 2-94), with tube dislodgement (n = 3) and clogging (n = 5) as the main complications. NET feeding resulted in complete healing of gastrocutaneous fistulae in 5 of 6 patients and provision of total enteral nutrition in 3 of 4 cases of acute pancreatitis and 9 of 11 cases of gastroparesis or proximal duodenal obstruction. Transnasal endoscopy has a role in the placement of NET in non-critically ill patients requiring postpyloric feeding. However, there are some limitations, particularly in cases with altered duodenal anatomy. |
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Authors:
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Sanjiv Mahadeva; Abdul Malik; Ida Hilmi; Choon-Seng Qua; Choon-Heng Wong; Khean-Lee Goh |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition Volume: 23 ISSN: 0884-5336 ISO Abbreviation: Nutr Clin Pract Publication Date: 2008 Apr-May |
Date Detail:
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Created Date: 2008-04-08 Completed Date: 2008-08-11 Revised Date: 2010-04-29 |
Medline Journal Info:
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Nlm Unique ID: 8606733 Medline TA: Nutr Clin Pract Country: United States |
Other Details:
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Languages: eng Pagination: 176-81 Citation Subset: IM; N |
Affiliation:
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Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. sanjiv@ummc.edu.my |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Endoscopy, Digestive System / methods* Enteral Nutrition / instrumentation, methods* Female Fluoroscopy Humans Intubation, Gastrointestinal / adverse effects, instrumentation, methods* Male Middle Aged Time Factors Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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