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.
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 illpatients 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: Jennifer A Sim; M Horowitz; M J Summers; L G Trahair; R S Goud; A V Zaknic; T Hausken; J D Fraser; M J Chapman; K L Jones; A M Deane Journal: Intensive Care Med Date: 2012-10-25 Impact factor: 17.440
Authors: Adam M Deane; Matthew J Summers; Antony V Zaknic; Marianne J Chapman; Robert J L Fraser; Anna E Di Bartolomeo; Judith M Wishart; Michael Horowitz Journal: Crit Care Date: 2011-01-21 Impact factor: 9.097
Authors: Adam M Deane; M Deane Adam; Rupinder Dhaliwal; Dhaliwal Rupinder; Andrew G Day; G Day Andrew; Emma J Ridley; J Ridley Emma; Andrew R Davies; R Davies Andrew; Daren K Heyland; K Heyland Daren Journal: Crit Care Date: 2013-06-21 Impact factor: 9.097
Authors: Anna E Di Bartolomeo; Marianne J Chapman; Antony V Zaknic; Matthew J Summers; Karen L Jones; Nam Q Nguyen; Christopher K Rayner; Michael Horowitz; Adam M Deane Journal: Crit Care Date: 2012-09-17 Impact factor: 9.097
Authors: Rob J J van Gassel; Marcel C G van de Poll; Frank G Schaap; Mark Plummer; Adam Deane; Steven W M Olde Damink Journal: JPEN J Parenter Enteral Nutr Date: 2021-05-06 Impact factor: 3.896