A variety of methods for the placement of nasoenteric feeding tubes in critically ill patients have been reported. These methods include blind placement by nurses, endoscopic placement by gastroenterologists and placement under fluoroscopic guidance by interventional radiologists. We provide procedural details and report our experience with placement of nasoenteric feeding tubes at the bedside, using fluoroscopic guidance, by trained mid-level practitioners.
In this chapter we have reviewed our previously published results (Hauschild et al. 2012). Trained nurse practitioners placed 632 nasoenteric feeding tubes at the bedside, under fluoroscopic guidance, in 462 patients. The majority of these patients were mechanically ventilated. The vast majority (97 %) of tubes were placed distal to the pylorus. Mean fluoroscopy time was 0.7 ± 1.2 min, and the mean procedure time was 7.0 ± 5.1 min. All tubes were placed within 24 h of request. There were no complications. Institutional charges for feeding tube placement were $149 for nurse practitioners, $226 for gastroenterologists, and $328 for interventional radiologists.
Bedside placement of nasoenteric feeding tubes in critically ill patients under fluoroscopic guidance by trained mid-level practitioners is safe, effective, timely, and may be less costly compared to tubes placed by gastroenterologists or interventional radiologists.
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