Document Detail


Transnasal endoscopic placement of nasoenteric feeding tubes: outcomes and limitations in non-critically ill patients.
MedLine Citation:
PMID:  18390786     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Sanjiv Mahadeva; Abdul Malik; Ida Hilmi; Choon-Seng Qua; Choon-Heng Wong; Khean-Lee Goh
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Publication Detail:
Type:  Journal Article    
Journal Detail:
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:
Created Date:  2008-04-08     Completed Date:  2008-08-11     Revised Date:  2010-04-29    
Medline Journal Info:
Nlm Unique ID:  8606733     Medline TA:  Nutr Clin Pract     Country:  United States    
Other Details:
Languages:  eng     Pagination:  176-81     Citation Subset:  IM; N    
Affiliation:
Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. sanjiv@ummc.edu.my
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MeSH Terms
Descriptor/Qualifier:
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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