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Critical Care Setting of Bedside Positioning of Electromagnetically Guided Nasointestinal Tubes

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Diet and Nutrition in Critical Care

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Abstract

Sufficient enteral nutrition of critically ill patients is challenging and about 50 % of patients fail to reach required caloric intake. A common reason is delayed gastric emptying. In those cases, postpyloric feeding is recommended. Blind placement of nasointestinal feeding tubes is not effective because tubes frequently do not pass the pylorus and remain in the stomach. However, sometimes tubes pass the pylorus by use of prokinetics or natural propulsion several hours later. Endoscopic or radiologic guided placement of postpyloric tube is more effective but raises the risks for critically ill patients in terms of delayed enteral nutrition and, in some cases, “out-of-ward procedures.” Bedside placement of electromagnetically guided nasointestinal tube (EGNT) provides fast tube placement and thus reduces X-ray exposure and risks of out-of-ward transports and enhances caloric intake. Bedside EGNT placement is proven to be safe and effective in intensive care patients. Most placements succeed, even in patients after upper gastrointestinal (GI) surgery.

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Abbreviations

EGNT:

Electromagnetically guided nasointestinal tube

EMG:

Electromagnetic

GI:

Gastrointestinal

ICU:

Intensive care unit

PEG:

Percutaneous endoscopic gastrostomy tubes

References

  • Bercik P, Schlageter V, Mauro M, et al. Noninvasive verification of nasogastric tube placement using a magnet-tracking system: a pilot study in healthy subjects. J Parenter Enteral Nutr. 2006;29(4):305–10.

    Article  Google Scholar 

  • Berry S, Orr M, Schoettker P, et al. Intestinal placement of pH-sensing nasointestinal feeding tubes. JPEN J Parenter Enteral Nutr. 1994;18(1):67–70.

    Article  CAS  PubMed  Google Scholar 

  • Davidson JE, Callery C. Care of the obesity surgery patient requiring immediate-level care or intensive care. Obes Surg. 2001;11(1):93–7.

    Article  CAS  PubMed  Google Scholar 

  • Dobbie RP, Hoffmeister JA. Continuous pump-tube enteric hyperalimentation. Surg Gynecol Obstet. 1976;143(2):273–6.

    CAS  PubMed  Google Scholar 

  • Frederick PR, Miller MH, Morrison WJ. Feeding tube for fluoroscopic placement. Radiology. 1982;145(3):847.

    Article  CAS  PubMed  Google Scholar 

  • Gabriel SA, Ackermann RJ. Placement of nasoenteral feeding tubes using external magnetic guidance. JPEN J Parenter Enteral Nutr. 2004;28(2):119–22.

    Article  PubMed  Google Scholar 

  • Grant JP, Curtas MS, Kelvin FM. Fluoroscopic placement of nasojejunal feeding tubes with immediate feeding using a nonelemental diet. J Parenter Enteral Nutr. 1983;7(3):299–303.

    Article  CAS  Google Scholar 

  • Gray R, Tynan C, Reed L, et al. Bedside electromagnetic-guided feeding tube placement: an improvement over traditional placement technique? Nutr Clin Pract. 2007;22(4):436–44.

    Article  PubMed  Google Scholar 

  • Hemington-Gorse SJ, Sheppard NN, Martin R, et al. The use of the Cortrak enteral access system for post-pyloric (PP) feeding tube placement in a burns intensive care unit. Burns. 2011;37(2):277–80.

    Article  CAS  PubMed  Google Scholar 

  • Holzinger U, Brunner R, Miehsler W, et al. Jejunal tube placement in critically ill patients: a prospective, randomized trial comparing the endoscopic technique with the electromagnetically visualized method. Crit Care Med. 2011;39(1):73–7.

    Article  PubMed  Google Scholar 

  • Hsu CW, Sun SF, Lin SL, et al. Duodenal versus gastric feeding in medical intensive care unit patients: a prospective, randomized, clinical study. Crit Care Med. 2009;37(6):1866–72.

    Article  PubMed  Google Scholar 

  • Kaffarnik MF, Lock JF, Wassilew G, et al. The use of bedside electromagnetically guided nasointestinal tube for jejunal feeding of critical ill surgical patients. Technol Health Care. 2013;21(1):1–8.

    PubMed  Google Scholar 

  • Kearns PJ, Donna C. A controlled comparison of traditional feeding tube verification methods to a bedside, electromagnetic technique. JPEN J Parenter Enteral Nutr. 2001;25(4):210–5.

    Article  CAS  PubMed  Google Scholar 

  • Keidan I, Gallagher TJ. Electrocardiogram-guided placement of enteral feeding tubes. Crit Care Med. 2000;28(7):2631–3.

    Article  CAS  PubMed  Google Scholar 

  • Kline AM, Sorce L, Sullivan C, et al. Use of a noninvasive electromagnetic device to place transpyloric feeding tubes in critically ill children. Am J Crit Care. 2011;20(6):453–9. quiz 460.

    Article  PubMed  Google Scholar 

  • Kreymann KG, Berger MM, Deutz NE, et al. ESPEN guidelines on enteral nutrition: intensive care. Clin Nutr. 2006;25(2):210–23.

    Article  CAS  PubMed  Google Scholar 

  • Lei K, Smith J, Camporota L, et al. Cortrak magnetic device to facilitate early enteral feeding in critically ill patients. Crit Care. 2007;11(S2):151.

    Article  Google Scholar 

  • Levy H, Hayes J, Boivin M, et al. Transpyloric feeding tube placement in critically ill patients using electromyogram and erythromycin infusion. Chest. 2004;125(2):587–91.

    Article  PubMed  Google Scholar 

  • McClave SA, Martindale RG, Vanek VW, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically Ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). JPEN J Parenter Enteral Nutr. 2009;33(3):277–316.

    Article  PubMed  Google Scholar 

  • Munera-Seeley V, Ochoa JB, Brown N, et al. Use of a colorimetric carbon dioxide sensor for nasoenteric feeding tube placement in critical care patients compared with clinical methods and radiography. Nutr Clin Pract. 2008;23(3):318–21.

    Article  PubMed  Google Scholar 

  • October TW, Hardart GE. Successful placement of postpyloric enteral tubes using electromagnetic guidance in critically ill children. Pediatr Crit Care Med. 2009;10(2):196–200.

    Article  PubMed  Google Scholar 

  • Phang J, Marsh W, Prager R. Feeding tube placement with the aid of a new electromagnetic transmitter [abstract]. J Parenter Enteral Nutr. 2006;30:S48–9.

    Google Scholar 

  • Powers J, Luebbehusen M, Spitzer T, et al. Verification of an electromagnetic placement device compared with abdominal radiograph to predict accuracy of feeding tube placement. JPEN J Parenter Enteral Nutr. 2011;35(4):535–9.

    Article  PubMed  Google Scholar 

  • Rao MM, Kallam R, Flindall I, et al. Use of Cortrak – an electromagnetic sensing device in placement of enteral feeding tubes. Proc Nutr Soc. 2007;67:E109.

    Article  Google Scholar 

  • Rivera R, Campana J, Hamilton C, et al. Small bowel feeding tube placement using an electromagnetic tube placement device: accuracy of tip location. JPEN J Parenter Enteral Nutr. 2011;35(5):636–42.

    Article  PubMed  Google Scholar 

  • Roberts S, Echeverria P, Gabriel SA. Devices and techniques for bedside enteral feeding tube placement. Nutr Clin Pract. 2007;22(4):412–20.

    Article  PubMed  Google Scholar 

  • Salasidis R, Fleiszer T, Johnston R. Air insufflation technique of enteral tube insertion: a randomized, controlled trial. Crit Care Med. 1998;26(6):1036–9.

    Article  CAS  PubMed  Google Scholar 

  • Simpson F, Doig GS. Parenteral vs. enteral nutrition in the critically ill patient: a meta-analysis of trials using the intention to treat principle. Intensive Care Med. 2005;31(1):12–23.

    Article  PubMed  Google Scholar 

  • Stapleton RD, Jones N, Heyland DK. Feeding critically ill patients: what is the optimal amount of energy? Crit Care Med. 2007;35(9 Suppl):S535–40.

    Article  PubMed  Google Scholar 

  • Taylor SJ, Manara AR, Brown J. Treating delayed gastric emptying in critical illness: metoclopramide, erythromycin, and bedside (Cortrak) nasointestinal tube placement. JPEN J Parenter Enteral Nutr. 2010;34(3):289–94.

    Article  PubMed  Google Scholar 

  • Thurlow PM. Bedside enteral feeding tube placement into duodenum and jejunum. JPEN J Parenter Enteral Nutr. 1986;10(1):104–5.

    Article  CAS  PubMed  Google Scholar 

  • Weimann A, Braga M, Harsanyi L, et al. ESPEN guidelines on enteral nutrition: surgery including organ transplantation. Clin Nutr. 2006;25(2):224–44.

    Article  CAS  PubMed  Google Scholar 

  • Windle EM, Beddow D, Hall E, et al. Implementation of an electromagnetic imaging system to facilitate nasogastric and post-pyloric feeding tube placement in patients with and without critical illness. J Hum Nutr Diet. 2010;23(1):61–8.

    Article  CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of General, Visceral and Transplantation Surgery, Charité – Universitätsmedizin Berlin, Augustenburger Platz 1, Berlin, 13353, Germany

    Magnus F. Kaffarnik

  2. Department of General-, Visceral-, Vascular- and Paediatric Surgery, University Hospital of Wuerzburg, Oberduerrbacherstraße 6, Wuerzburg, 97080, Germany

    Johan F. Lock

Authors
  1. Magnus F. Kaffarnik
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  2. Johan F. Lock
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Corresponding author

Correspondence to Magnus F. Kaffarnik .

Editor information

Editors and Affiliations

  1. Royal Free London Hospitals, Barnet General Hospital, London, UK

    Rajkumar Rajendram

  2. Division of Diabetes & Nutritional Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, UK

    Rajkumar Rajendram

  3. King Khalid University Hospital, King Saud University Medical City, Riyadh, Saudi Arabia

    Rajkumar Rajendram

  4. Department of Nutrition and Dietetics, Division of Diabetes & Nutritional Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, UK

    Victor R. Preedy

  5. Department of Biomedical Sciences, Faculty of Science & Technology, University of Westminster, London, UK

    Vinood B. Patel

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Kaffarnik, M.F., Lock, J.F. (2015). Critical Care Setting of Bedside Positioning of Electromagnetically Guided Nasointestinal Tubes. In: Rajendram, R., Preedy, V.R., Patel, V.B. (eds) Diet and Nutrition in Critical Care. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7836-2_25

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  • DOI: https://doi.org/10.1007/978-1-4614-7836-2_25

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-7837-9

  • Online ISBN: 978-1-4614-7836-2

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